Application for Training Please complete the following application. Once received you will be sent a full application. Please indicate how you would like to receive the application:(Required) Mail E-mail Please indicate your title(Required) Mr. Mrs. Miss. Ms. First and Last Name(Required) First Last Address(Required) Address City Province Postal Code Home Phone Number(Required)Work Phone NumberEmail Address Health Insurance Plan # Date of Birth(Required) Are you registered blind(Required) Yes No Have you had a low vision assessment?(Required) Yes No Are you a long cane user?(Required) Yes No Have you had a guide dog before?(Required) Yes No Have you applied to other guide dog schools? Yes No Have you applied to Canadian Guide Dogs for the Blind before?(Required) Yes No Canadian Guide Dogs for the Blind is committed to protecting the privacy, confidentiality, accuracy, and security of any personal information that we collect, use, retain, and disclose in the course of the programs we offer. By clicking submit, you give Canadian Guide Dogs for the Blind permission to use your information for the purpose of your application for a guide dog. Δ
