Create a My GDUC Account

Please complete required fields and press the Save button. Required fields appear in bold and are preceded by a red asterisk (*):

*First name:

*Last name:

*Email address:

Phone number:

Alternate phone number:

Password (leave blank to have one generated):

Password again (leave blank to have one generated):

*Communication format:

Working, previously worked, or potentially eligible to work with a guide dog:

GDUC chapter:

Assist GDUC by volunteering:

*How did you learn about GDUC?:

*Address line 1:

Address line 2:

*City:

*Province/state:

*Postal code:

*Country:

Comments:

Birth date - month:Birth date - day:Birth date - year:

*To prevent spam, please type the following numbers - 54106: