Guiding Eyes for the Blind Student Application

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Page 1/5: Eligibility Requirements

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! 

In order to apply for a Guiding Eyes guide dog, you must meet the following criteria:
  1. You are legally blind. Legal blindness is defined as having a visual acuity of 20/200 or less in the better-seeing eye with correction or a visual field of 20 degrees or less.
  2. You are at least 16 years old. There is no upper age limit for applicants.
  3. You live in the United States or Canada. Residents of other countries should visit the International Guide Dog Federation at this link: https://www.igdf.org.uk
  4. You can be responsible for the care of a dog. For example: feeding, watering, relief breaks, veterinary care, play time, etc. (Please note that there is no cost to our training program. Graduates can expect to pay $80-$100 per month in dog food/supply costs. We provide a stipend to every graduate of $600 per calendar year to cover basic veterinary care for their working guide dog. Graduates are responsible for veterinary costs that exceed this stipend.)
  5. You walk outdoors regularly and independently, using a white cane or guide dog to navigate. Please note, applicants must provide 2 to 3 routes they travel regularly on their application.
  6. You have had Orientation and Mobility training, sometimes referred to as Travel Training or White Cane Training.

Unsure about Eligibility
Thank you for your interest in a guide dog from Guiding Eyes for the Blind. Our Admissions Team is happy to help you determine if you are eligible to apply and we can be reached by emailing admissions@guidingeyes.org or by calling 888-987-2188. To exit, close this page.
 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 

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. The information requested includes your contact details, history of Orientation & Mobility Training, history of any guide dog training, and a description of your routine travel.  An * at the end of a word means the information is required. If you believe a particular question or section does not apply to you, please enter “not applicable” or “NA”. There are 5 pages in this form, and you must fill all required fields on your current page before you can continue on to the next page. You can select the “Save my progress and resume later” checkbox at the top of the screen at any time. Please note you will be asked to enter an email address and create a password to use this feature.  

Please acknowledge you have read and understand the Non-Discrimination and Privacy Statement by clicking the Next Page button at the bottom of this screen. The application begins on the next page. 

Page 2/5: Orientation and Mobility Reference and Contact Information

An * at the end of a word means the information is required. If you believe a particular question or section does not apply to you, please enter “not applicable” or “NA”. There are 5 pages in this form, and you must fill all required fields on your current page before you can continue on to the next page.
Orientation & Mobility Reference

No Orientation & Mobility Training
Unfortunately, you are not eligible to apply at this time because you have not received orientation and mobility training. Please contact the Admissions Team at admissions@guidingeyes.org or call 888-987-2188 for more information and resources. To exit, close this page.
Please provide us with the following O&M information:
Example: johnsmith@email.com
Please provide us with the following O&M information:
Example: johnsmith@email.com
Personal Contact Information
As noted on ID or passport
As noted on ID or passport
Example: johnsmith@email.com
Example: johnsmith@email.com
Example: johnsmith@email.com
Example: johnsmith@email.com
Example: johnsmith@email.com
Example: johnsmith@email.com
Enter emergency contact's full name and relation to you.
Example: johnsmith@email.com



GEB Admissions Only

Page 3/5: Personal Information and Home Area

An * at the end of a word means the information is required. If you believe a particular question or section does not apply to you, please enter “not applicable” or “NA”. There are 5 pages in this form, and you must fill all required fields on your current page before you can continue on to the next page.
Personal Information

Enter four digit year, Ex: 01/03/2001, not 01/03/01
Optional questions used for statistical purposes:
Tell Us About Yourself













Current Travel in Home Area




Please note: Guiding Eyes for the Blind does not train our guide dogs to guide individuals in wheelchairs, walkers, or scooters at this time

Page 4/5: Routes, Personal References, and Running

An * at the end of a word means the information is required. If you believe a particular question or section does not apply to you, please enter “not applicable” or “NA”. There are 5 pages in this form, and you must fill all required fields on your current page before you can continue on to the next page.
Routes
Please provide us with descriptions of three of the routes that you travel most frequently. If you have fewer than three routes, please provide as much information as possible about those routes.
Route 1




For the following three questions, please select all that apply.



Route 2




For the following three questions, please select all that apply.



Route 3




For the following three questions, please select all that apply.



Personal References
Please provide us with the names and contact information for one or two personal references that are not related to you
Personal Reference 1

Personal Reference 2

Running Guide Dog Section


Page 5/5: Conclusion

Once you are ready to submit your application, click the “Continue” button at the bottom of the page. A "Please Review your responses and Confirm" screen will appear. At the bottom of the page you will have options to Make a Correction, Print, or Confirm. 

Completing this application places neither Guiding Eyes for the Blind, Inc, or yourself under any obligation. Any applicant denied admissions may appeal the decision through our appeals process or subsequently reapply.  

Thank you and we look forward to working with you! 

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