Register your interest in Adopting a dog
To submit an application you must be over 18 years old and will need a valid credit card to pay the processing fee of $25 for your application.
Section 1 - Prerequisites
Are you over 18 years of age?
Sorry, you cannot proceed with the application. You need to be over the age of 18 to formally adopt a dog.
Is your section fenced?
Please state the materials and height of the fence
Sorry, but you cannot proceed with the application. We require your section to have dog proof fencing as one of the requirements for adopting a dog.
Do you guarantee the dog will live and sleep inside as a member of the family?
Sorry, but you cannot proceed with the application. Our dogs have been brought up to be companion dogs and therefore need to live/sleep inside.
Will the dog be left alone for more than 3-4 hours per day?
You can still proceed with the application, however we need more details (e.g. why, how long for, how often)?
Section 2 - Personal Details
The Right Hon
How can we get in touch with you?
Preferred Contact Method
What is your current address?
Section 3 - Your home
Do you have children living with you?
Please provide details (especially number and age of your children)
Is anyone in your home elderly?
Please provide details
What type of area do you live in?
Section 4 - Your experience with dogs
Have you owned a dog previously?
Please provide dog
Please state previous experience with dogs, if any
Do you currently have a dog?
How many dogs, what are their breeds, ages and genders?
Do you own any other pets?
Please state what kind of pets and how many
Section 5 - Your adoption preferences
Are you wanting to adopt a Guide Dog
As a pet
As a companion dog
Please Note: A companion dog is a pet dog for a disabled person who does not require a Guide Dog
Please explain the reasons for wanting a companion dog, and also if this is for yourself or on behalf of someone with a disability
Age preference of adopted dog?
Under 12 months
12 months to 18 months
18 months to 9 years
9 years to 12 years
Acceptable medical conditions and associated ongoing costs of adopted dogs?
Arthritis (elderly/retired dog)
Hip or elbow dysplasia
None of the above
What gender of dog would you consider?
What are your breed preferences?
Labrador Cross Golden Retriever
Payment Information - Processing Fee
Blind Low Vision NZ request you pay a processing fee with your Application of $25 via Credit Card. Your credit card will be charged on form submit and the amount is non-refundable. If the transaction is not successful, the application will not be submitted.
This fee does NOT guarantee that you will receive one of our dogs.
If you are successful in adopting a dog, an additional adoption fee will apply to a maximum of $1,250.
Name on Card
The CVV/CVC code (Card Verification Value/Code) is located on the back of your credit/debit card on the right side of the white signature strip; it is always the last 3 digits in case of VISA and MasterCard.
Before you submit your request
Where did you hear about us?
Blind Low Vision NZ website
Email from Blind Low Vision NZ
From a friend or family member
From a fundraising campaign
From a medical professional
In the post
Any other comments or information you would like to give us?
Your Rights & Privacy
Blind Low Vision NZ is governed by the Health and Disability Code of Rights. Click here to find out about your rights under the Code.
Blind Low Vision NZ is committed to protecting your privacy and works in accordance with the Privacy Act 2020. Click here to find out about the Privacy Act 2020.
Blind Low Vision NZ will keep your information confidential, as outlined in our
. Click here to open our privacy statement.
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