Virtual Camp GDB 2021

Open to youth who are blind or visually impaired, ages 14-17, who are interested in the guide dog lifestyle and considering a guide dog for mobility.

Date(s): June 28- July 2, 2021
Location: Zoom
Room for 24 participants

Application Deadline: Friday, June 11, 2021

Question Title

* 1. First and Last Name

Question Title

* 2. Personal Pronouns

Question Title

* 3. Date of Birth

Question Title

* 4. Email Address

Question Title

* 5. Address

Question Title

* 6. City, State, Zip

Question Title

* 7. Home Phone Number

Question Title

* 8. Camper's Cell Phone Number

Question Title

* 9. Ethnicity (Optional)

Question Title

* 10. Primary Language Spoken

Question Title

* 11. Are you legally blind?

Question Title

* 12. Are you totally blind or partially sighted?

Question Title

* 13. If visually impaired, please describe your functional vision.

Question Title

* 14. What is the cause of your visual impairment?

Question Title

* 15. Aside from blindness, please list and describe any other physical and/or cognitive disabilities.

Question Title

* 16. Do you currently use a mobility aid?

Question Title

* 17. If yes, please indicate what kind of mobility aid you currently use.

Question Title

* 18. Tell us about your experience with dogs, if any?

Question Title

* 19. Have you attended Camp GDB before?

Question Title

* 20. If yes, when?

Question Title

* 21. Why do you want to attend Camp GDB?

Question Title

* 22. How do you prefer to receive printed materials?

Question Title

* 23. Camper's t-shirt size

0 of 23 answered
 

T