Weekend Homer Application

Applicant Details

Application Type *

Salutation *

First Name *

Surname *

Identity Type *

ID Number *

Email Address*

Mobile Number*

Gender *

Interest In Guide Dogs *

Secondary Person Contact Details

First Name *

Surname *

ID Number *

Gender *

Phone Number *

Email Address*

Occupation *

Address Information

Residence *

Property *

Home Address *

Postal Address *

City *

Province *

Own Animals Information

Do you have currently any pets? *

Are your dogs sterilised,Vacinated,Socialized? If not, why? *

Other Information

Children (with ages) *

Differently abled people in the home? If yes, please specifiy *

General Information Details

Where do your own dog/s sleep? *

Where will the GDA dog sleep?*

What bed will be provided for the GDA puppy? *

Where does your own dog/s eat? *

Where will the GDA puppy eat? *

How many times a day does your own dog/s eat? *

If you have cat/s where do they eat? where are the bowls kept? *

Does your cat/s have a litter box? if yes , where? *

Is your cat/s socialised with dog/s and a variety of breeds? *

Where did you hear of the PRP? *

Socialising and Training Details

Do you take your own dogs to dog parks?*

Have your own dog/s attended Socialization classes, if any, which public school*

Property Information

Do you have any of the following? *

Do your own dogs swim? *

Type of Perimeter *

Height at lowest point? *

Height at highest point? *

Do you have seperate back garden? *

Do you have a courtyard? *

Is your driveway closed off from the front gate?*

How many flights of stairs do you have if any?*

Can the stairs be cornered off,if you have any?*

Do you use any pesticides or poisons in or around your home and garden? if so, which products do you use?*

Do you have a double – story property with a staircase? if yes, are they open or closed?*

Additional Personal Details

Please tell us a little about yourself*