Puppy Walker Application

Yes! I want to become a Puppy Walker and help a puppy become a guide dog!

Name


Street Address



City


State


Zip


Telephone (Day)


Telephone (Night)


E-mail address


Is your family willing to devote time each day to the care and education of a guide dog puppy?
Yes No

Which person will assume primary responsibility for the care of the puppy?


Is any family member allergic to, or afraid of, dogs?
Yes No

If “Yes,” please specify.


Have you raised a puppy in the past?
Yes No

Do you currently have any pets at home?
Yes No

If “Yes,” what kind(s)?


Do you have a dog at home?
Yes No

If “Yes,” how does it react to strangers?
Please specify.


If “Yes,” how does it react to loud noises (such as firecrackers)?
Please specify.


If “Yes,” how does it react to thunder?
Please specify.


If “Yes,” how does it react to other animals?
Please specify.


Do you have a fenced-in yard?
Yes No

If “Yes,” what height is it?


Is your family willing to absorb the cost of feeding a guide dog puppy our specified diet? (Food is estimated at $30 per month.)
Yes No

Comments/Notes