Guiding Eyes for the Blind Student Application

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We are pleased that you’ve chosen to apply with Guiding Eyes for the Blind. We’re dedicated to finding an ideally matched dog for you based on a deep understanding of your lifestyle. We design our training programs around your individual needs. Your thorough completion of this application will help us determine if a Guiding Eyes guide dog is the right choice for you and how we can best work with you to achieve your goals, thank you!
 Non-Discrimination and Privacy Statement

Guiding Eyes for the Blind does not discriminate against any applicant for admission to our guide dog programs based on race, religion, color, national origin, ancestry, age, marital status, gender or any other factor prohibited under local, state or federal laws.  Providing race and/or ethnicity information is optional and used for statistical purposes only.  As part of the application process, Guiding Eyes for the Blind, Inc. may conduct reference and criminal background checks on all applicants. Contact the Admissions Department if you would like to provide us with background information that will assist in these areas.  Any information collected during the application process will be kept confidential.


If you have any questions or concerns about discrimination or privacy, please contact the Client Experience Team at 888-987-2188 or clientexperience@guidingeyes.org.

Instructions

This application form will ask for a variety of information including your contact details, history of Orientation & Mobility Training, history of Guide Dog training if any, a description of your routine travels, and other relevant information. Your answers will help Guiding Eyes for the Blind get to know you and will aid in assessing your ability to successfully train with and utilize a guide dog. It is important that you do not skip questions. If you believe a particular question or section does not apply to you, please enter “not applicable” or “NA” rather than leaving that area blank. An * indicates a required field. If you need to save your form to continue later, there is a “save your responses and resume editing later" checkbox at the top of the screen. Please note that an email address is needed to save your responses and resume editing later. 

 

Once you have completed the entire application form, click the continue button at the bottom of the screen. You will then be asked to please review your responses on the form and confirm them. At the bottom of the screen there will be options to make a correction, print a copy, or confirm.  Selecting the confirm option finalizes and submits your form, so be sure you are done making changes before confirming.

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Legal Name
As noted on ID or passport
As noted on ID or passport
Contact Information
Enter name, relation and phone number of person(s) to contact in case of emergency
 Please review the eligibility requirements and information below:

1.  Walk outdoors regularly unaccompanied and independently using a white cane or guide dog.

2.  Can be responsible for the care of a dog.

3.  Have had Orientation and Mobility training.

4.  Are legally blind.

5.  Are over 16 years of age (If you are 15, you are welcome to apply if you will be turning 16 during the application process).

6.  Live in the United States or Canada (residents of other countries should visit the International Guide Dog Federation).


There is no cost to our training program, however, graduates are responsible for the costs of feeding and caring for their guide dog. Graduates can expect to pay $80-$100 per month in dog food costs. We provide a stipend to every graduate of $500 per calendar year to cover basic veterinary care for their working guide dog (this stipend does not apply to retired guide dogs). Graduates are responsible for veterinary costs that exceed this stipend. Keep in mind as well that, like people, most dogs require more veterinary care as they age.

GEB Admissions Only

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Contact Information
Home Address

How do you prefer to receive written communications?
Personal Information
Name you like to be called
Enter four digit year, Ex: 1/3/2001, not 1/3/01





References
Please provide contact information for your Orientation and Mobility instructor so that we can contact them as a reference. If you have not worked with them in the past 5 years, this section is optional.
Phone of person giving reference
Address of person giving reference
Please provide us with the names and contact information for two personal references that aren't related to you.
Personal Reference 1
Personal Reference 2

Other Guide Dog School History



Current Travel in Home Area - Please provide us with descriptions of up to the three routes you travel most frequently
Route 1


Route 2

Daily, 2xweek, weekends only

Route 3

Daily, 2xweek, weekends only

Additional Questions





Health Questions







Programs Offered

Residential Program: Three-week program held at our training center in Yorktown Heights, NY. Students have their own room and bath, equipped with a TV and refrigerator.  Training begins on our campus and progresses to nearby towns and cities.  Eventually, students train in custom locations which can include New York City to individually prepare them for their home environment.

 

Home Training Program: In order to qualify for Home Training, you must demonstrate a reason why you cannot attend our Residential Program. For example: Child Care, Work Obligations, Caring for an Elderly Parent, etc.  Our Home Training program may be an option for both first-time and repeat guide dog users.  Training will be conducted in your home environment for 10-15 days depending your experience working with a Guide Dog.


Specialized Training Program: Students can be served through the Residential or Home Training Programs.  Specialized Training instructors design training programs suited to accommodate each student's individual needs.  These instructors are also trained in tactile American Sign Language to communicate with those who are DeafBlind.



Congratulations, you have reached the end of the application! To ensure you do not lose the information you entered, please save your progress if you have not already done so. You can do this by tabbing to the “Save my progress and resume later” checkbox at the bottom or top of the screen. You will be asked to enter your email address and create a password. Once you have done so, please click save. You can then access the saved copy of your form by clicking the “Resume this form now” option. You will also receive an automated email message with a link to resume the saved form if you need to come back to it later. 

 

When you are ready to submit your application, find the continue button at the bottom of the screen. Once you press continue, you will be asked to please review your responses on the form and confirm them. At the bottom of the screen there will be options to make a correction or print a copy, as well as a confirm button. Please note that once you click the confirm button you will no longer be able to make changes and your application will be sent to the Admissions Team for review. If you receive an error when you are trying to submit your application, please carefully review the form and correct any missing or incorrectly formatted information. If you continue to receive an error and cannot locate the problem, please contact the Admissions Team by emailing admissions@guidingeyes.org or by calling 888-987-21188.  As long as you have saved a copy of your application, we should be able to find your form in the system and identify any issues.

Every application we receive is reviewed and processed by our Admissions Team who may reach out with questions or to request additional information. Once your application has been processed, you will receive an email message confirming your application was received and directing you to complete two release forms via links included in that message. Please be sure to complete both forms at your earliest availability, as you cannot move forward in the admissions process until we have received both release forms. Once we have received the needed releases, the Admissions Team will communicate the next steps of the admissions process, including additional forms and relevant deadlines. If you would prefer paper copies of any of the needed forms, please contact the Admissions Team at admissions@guidingeyes.org or by calling 888-987-2188. We can send printable versions of the forms by email or paper copies by regular mail. Please note that the Admissions Team will reach out with periodic reminders, but it is ultimately the applicant’s responsibility to ensure that the forms needed are completed. We welcome you to contact us with questions or to check on your progress throughout the admissions process.  


Completing this application places neither Guiding Eyes for the Blind, Inc., or yourself under any obligation. Any applicant denied admission may appeal the decision through our appeals process or subsequently reapply. We look forward to working with you!

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Contact Information