Application Form for a Canine Partner

For information about who can apply to be matched with a Canine Partners assistance dog, view and/or print the "who we can help" page. Please see our "Contact Us" page for all other enquiries.

• Are you 18 years of age or over?
• Do you have a disability that affects your mobility and quality of life?
• Do you feel that you would benefit from the help a Canine Partner can provide?
• Do you want the responsibility of looking after and working with one of our dogs?

If so, please call our Partnership & Aftercare Department on 01730 716 043 or complete the form below and we will send you an application pack. Your details will be treated confidentially. Canine Partners DO NOT train assistance dogs for people with Autism, Epilepsy or anyone under 18 years of age.

Use the links below for information on the five other registered charities that form Assistance Dogs UK: Guide Dogs for the Blind, Hearing Dogs for Deaf People, Dogs for the Disabled (physical disabilities and children with autism), Support Dogs (epilepsy, physical disabilities and children with autism) or Dog A.I.D (training pets).  

* Required
Title DR MISS MR MRS MS

First Name *

Last Name *

Email Address *

Home Address *

City *

County *

Postcode *

Contact Phone Number *

Mobile Phone Number

Please supply brief details of your disability and how you think a Canine Partner will benefit you:





How did you find us?:





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If you prefer, you can print off this application form (symbol above form gives a print view), fill it in and send to:

The Partnership Office
Canine Partners
Mill Lane
Heyshott
West Sussex
GU29 0ED

Tel: 01730 716 043 or 08456 580 480; Fax: 08456 580 481

Canine Partners for Independence. Registered in England No. 2516146. Charity Commission Registered No. 803680. Scottish Registered Charity No. SCO39050

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