First Name:    Last Name:  

Address Line1:     
 City:  State:   Zip: 

I am:  

If under 18, please provide parent/guardian information:
Parent/Guardian Name:

Parent/Guardian Email: 


Home Phone:   Work Phone:  
Cell Phone:   Email:   

Emergency Contact:  Name:  Phone:   Relationship: 

Taxi Team & Student Residence volunteers are required to have a current, valid, Driver's License.

License #:   State: 

You must be 18 years old and have a current valid driver's license to join these two groups.  
The Foundation checks license status.

AREAS OF INTEREST (Check all that apply)

   Hanging Flyers   Toy/Towel Drive        Class Volunteer
   Food Server    
   Office   Sewing Club
  Fundraising    Speaker's Bureau

Please list hours available as of today.

Please provide at least 2 personal references, not related to you.
If someone referred you, please fill in name.

Reference 1
Name   Phone   Address  

Reference 2  
Name:    Phone:   Address:   

Referred to us by

Name:   Phone Address 

How did you learn about us?  

In a few words, please describe what motivates you to volunteer with us. What are your volunteer goals?


Please list your work experience, specialized skills, talents or hobbies related to the volunteer positions that you checked.


Are you an active duty member or veteran of the United States Armed Forces?   

Is any other member of your household an active duty member or veteran of the United States Armed Forces?  

I affirm that the information provided in this application is true to the best of my knowledge.

Signature (Type full name):

The Guide Dog Foundation for the Blind, Inc., does not discriminate on the basis of sex, age, race, color, national and ethnic origin, disability, religion or marital status in the administration of its educational policies, admission policies, employment, volunteer and other administered programs.




I grant permission to the Guide Dog Foundation for the Blind Inc., its agents and employees, and to any person, company or organization that the Foundation may designate or authorize, to take photographs or videos of me during my volunteer activities as part of the Guide Dog Foundation program.

This consent includes the use of such photographs or films with or without my name or biographical data concerning me by the Foundation or another party on its behalf, without limitation as to time or frequency of use, for any or all of the following purposes:

1.Release to media, including newspapers and television

2.Educational or instructional purposes

3.Publicity or fund raising

4.Guide Dog Foundation publications, presentations, and related uses

I understand that the Guide Dog Foundation will try to notify me prior to using photos or videos of me, and I understand that such notification is not always possible.

Signature (Type full name):