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Guide Dogs
Puppy Raising
- Learn About Puppy Raising
- For Current Puppy Raisers
Access & Advocacy
Resources
You Can Help

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Applicant Vision Form

Name(Required)

Birthdate (mm/dd/yyyy)(Required)

Email(Required)

If you have any remaining vision or light perception, please answer the following questions:

1. Does your vision fluctuate under different lighting conditions? If so, please explain.

2. How long does it take you to focus your vision?

3. Are you able to read large print such as headlines in a newspaper or the brand name on a food label?

Yes

No

If yes, at what distance do you have to hold it to your eyes?

What font size is most comfortable for you?

4. When accessing information electronically on a computer or phone, do you use: (please select all that apply)

Speech Output

Screen Magnification

Braille Output

Other

Additional Remarks

5. Would all vision be cut off by wearing dark glasses?

Yes

No

6. Would you be willing to wear dark glasses when working with the dog if necessary?

Yes

No

7. Is vision corrected with glasses?

Yes

No

8. Has your vision changed significantly within approximately the last six months?

Yes

No

9. Please describe how your remaining vision affects your daily travel activities.

Additional Remarks

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The best place to get a guide dog.

We train Seeing Eye dogs to guide blind people, instruct blind people in their proper use, handling, and care, and conduct and support research on canine health and development.

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About Us
Guide Dogs
Puppy Raising
Access & Advocacy
Resources
You Can Help
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Contact

The Seeing Eye
P.O. Box 375
Morristown, NJ
07963-0375

(973) 539-4425
info@SeeingEye.org

Charity Navigator  4 Star Charity

Platinum level  Guidestar  

American Animal  Hospital Association

International Guide  Dog Federation

Assistance Dogs International

The Seeing Eye, Inc. is a registered United States nonprofit under IRS section 501(c)(3) with tax ID number 22-1539721.

The Seeing Eye does not discriminate on the basis of any legally protected class, including but not limited to race, color, or national or ethnic origin, religion, gender, gender expression, gender identity, sexual orientation, age, disability, or marital status in the administration of its admissions policies, instructional policies, loan programs, and other school-administered programs. The Seeing Eye is committed to equal opportunity, admits students without consideration of legally protected class, and affords all the rights, privileges, programs, and activities generally made available to students at the school.

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