Puppy Raiser Application - Independence Guide DogsIndependence Guide Dogs

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

Is everyone in your house excited about raising an Independence guide dog?*

Yes
No

Please list the names and ages of all family members.*

Are any family members allergic to dogs?*

Yes
No

Have you ever obedience trained a dog before?*

Yes
No

If yes, what breed?*

Have you ever raised a dog before?*

Yes
No

If yes, what breed?*

Do you have other dogs?*

Yes
No

If yes, please list breed, age, sex, and if spayed/neutered.*

How do they react to people?*

How do they react to other dogs?*

Are they house dogs or outdoor dogs?*

House
Outdoor

*Note: Independence Guide Dog puppies must be raised as house dogs.

What type of area do you live in?*

Rural
City
Residential

Do you have other animals?*

Yes
No

If yes, what type?*

How many hours a day will the puppy be left alone?*

Are there sidewalks near your home?*

Yes
No

Are you prepared to cover the cost of food for the puppy?*

Yes
No

Are you able to provide daily exercise for the puppy?*

Yes
No

Are you willing to socialize the puppy on a regular basis providing it exposure to people, sidewalks, and as they develop stores, restaurants and busy town areas?*

Yes
No

When would you like to begin raising the puppy?*

Do you have a preference of a male or female puppy?*

Yes
No

If yes, which is your preference and why?*

Please provide any additional comments you may have:

By submitting this application, I certify that I have reviewed the general information about raising an Independence Guide Dog puppy and I understand the commitment of time, money and love required to raise a pup.*

Yes, I certify

Subscribe to eNewsletter

Yes, please add me to your email list
No Thanks