Dog Adoption Application

Please read this document carefully before filling out the application below.

Note: to adopt one of our career change dogs, you will be required to visit the school campus in Sylmar, CA to meet the dog before your application can be approved.

Name
*

Address
*

City *
State * Zip *

Primary Phone
*

Secondary Phone

Email Address
*


Why do you want a career changed dog?
*

Please describe the type of career changed dog that you would like to adopt.
*

Breed Requested:
1st Choice *
2nd Choice *
3rd Choice

If a Labrador was your Choice, what is your color preference?
Indicate your 1st, 2nd, 3rd choice:
Yellow Black Chocolate Any

Sex of dog requested: *

Age preference: *

Would you accept an older dog or retired guide dog? *

Interested in a puppy? (Usually 8-10 weeks old) *

Would you accept a dog with hip *dysplasia? *

Hip Dysplasia is a genetic disorder that affects the breeds used in our program. Hip Dysplasia can range from mild to severe but many dogs are able to live long lives with the proper care. Treatment would vary with each individual dog. Hip Dysplasia is when the femur head (thigh bone) does not fit properly in the hip socket. Please contact your veterinarian for further information and advice on the disease.

Do you own or rent your home? *

Do you have landlord's permission to keep a dog?

Landlord's name and phone number

Do you live in a: *

If other, please describe:

Where will the dog spend the day? *
If other, please describe:

* You are required to submit at least three pictures of your backyard.

What kinds of activities do you plan to include your dog in on?
*

Are you willing to take the dog to an obedience class? *

Where will the dog be kept at night?
*

How many hours per day, on average, will the dog spend alone? *

Have you ever owned a dog in the past? *

What happened to the dog(s)?

Do you have children living at home? *
If so, what ages?

Do you have children who regularly visit? *
If so, what ages?

Do you own other dogs? *
If yes, how many?

Give breed and sex of each:

Are your dogs sterilized? *
If no, which are not:

Do you own cats? *

Do you own other animals? *

If yes, what other types of animals?

You are required to submit a letter of recommendation from your veterinarian. If you do not have a veterinarian then you will be required to submit a business card of the veterinarian that you plan on taking your dog to.

Would you be willing to let a representative of Guide Dogs of America visit your home by appointment? *
If no, Why?

Please understand that no guarantee whatsoever is made with regard to animals adopted from GDA, and that GDA will not knowingly misrepresent any animal or allow it to be adopted if it is suspected of being unhealthy. The non-refundable adoption fee is $400 for each dog and is due when you pick up your dog.

I certify that I am at least 18 years of age. All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with adequate food, water, shelter, training, affection, and medical care. I am in full agreement with the terms of adoption. Guide Dogs of America is neither liable nor responsible for any damage, accident, or injury from the placement of a dog in my household.

REMINDER:
You will need to call each year to verify your interest & update any information

WE RESERVE THE RIGHT TO REFUSE AN APPLICANT

* - Required

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