Financial support package for retired Guide Dogs

Apply for Reimbursement

Financial Support Request Form for retired Guide Dogs

If you require assistance or have any questions, please reach out to our Guide Dogs Administration Team at gdprogram@guidedogs.com.au. After completing this form, our team will be in contact with you to discuss your reimbursement request.

You can also download a PDF version of the form here to email in.

Fields marked with * requiredare required.

First Name * required

Surname * required

Contact Address

Street *(Flat, Unit No. and Street Name)

Suburb *

State *

Postcode *

Email * required

Phone Number Format: AreaCode + No.

Dog details

Retired Guide Dog Name * required

Please give a brief description of items you like to claim reimbursement for * required

Please provide copies of relevant receipts.* required ] Note that Guide Dogs NSW/ACT can only consider reimbursement where tax invoices and receipts are attached.

I declare that the information entered above is true and correct. * required

This package will be reviewed annually and should changes be required, Guide Dogs NSW/ACT will ensure appropriate consultation and communication.

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