| Shelterluv

Date

Address

Is the address you entered where the adoptee will live? Yes No

Is the same as your mailing address? Yes No

Phone Number

Landlord's Phone (if applicable)

Driver's License #

Driver's License State

What is your current living situation? Rent Own Moving Soon Currently Transitioning Living with Family/Friends House Apartment Townhouse/Condo Duplex Other

If you selected Other, please explain.

How long have you lived at this address?

Please mark which of the following are in your household. Other Dog(s) Cat(s) Children None of the above

Does your landlord permit pets?

If you marked yes, what is the pet deposit?

Is there a limit to the number of pets allowed in your home?

If yes, how many?

Is there a limit to the size of pets allowed in your home? If yes, what size?

Are there any breed restrictions in your area? If yes, what breeds?

Do you have a fenced in yard?

If you do have a fence, what is the height / type of fence?

Smoking

Do you allow smoking of any kind in your home? This included vaporization and any tobacco products

Do you currently own any animals? Yes No

List the name, species, breed and age of any pets that currently reside in your home.

Are your current pets altered (spayed/neutered)?

If no, please explain why

What is the name and number of your current veterinarian?

If you currently have pets, please send their vet records to 636-210-6166 with your name included.

Your application cannot be processed without this step. Please mark YES to note you understand.

Do you use flea / tick and heart-worm prevention?

If no, please explain why

Please list anyone living in address you provided, along with their ages and relationship to you:

Does anyone in your home suffer from allergies or asthma?

If so, how will these symptoms be managed?

Who is/will be the primary caretaker of your pet(s)?

If traveling, who will provide care to your pet(s)?

If you move, what will you do with your pet(s)?

What do you look for in an animal when adopting?

Why do you want to do adopt?

Are there specific breeds you're interested in?

If so, please state which ones and why

If you have a specific animal of ours in mind, which animal are you interested in?

If so, please include why you're interested in him or her.

Under what circumstances would you NOT keep this animal?

How much training do you intend to do on a scale of 1-5?

1 = None. 5 = Intensive training. This questions helps us match you with the right dog!

How much experience do you have with dog ownership on a scale of 1-5?

1 = No experience. 5 = Dog expert!

How much exercise do you realistically intend to do with your dog on a scale of 1-5?

1 = Low intensity, infrequent exercise. 5 = High intensity, high frequency exercise.

Have you previously owned pets?

If yes, please include what happened to them and the name of their vet.

Where will the pet spend most of their time?

When indoors, will the pet have free roam of the home?

If no, how will they be contained?

Have you ever gotten rid of an animal?

If yes, please explain why

Please read the terms and conditions. Initial here to signify your agreement to these terms.

I agree to communicate any medical issues the dog has to the foster facilitator if I have not paid for the adoption fee. I will contact the foster facilitator at Home 2 Home Canine Orphanage immediately and to only take the animal to the vet authorized by H2H, until I take full ownership of the animal and pay the adoption fee. I will not take the animal to my own vet or any vet not authorized by Home 2 Home Canine Orphanage prior to the adoption fee. If I do I hereby understand and agree that is my financial responsibility. Sign Initials

Please send a Home Video showing your inside and outside living space to 636-210-6166.

You will be sending in a home video to 636-210-6166. Type yes to verify you know you need to submit a video to the email address given. Start by a very brief hello this is me and then begin at the front door open the front door walk through the home to the back yard. If in an apartment and have a dog park make sure to add an additional video of that.

Additional Perks of an Adoption Through H2H

Here we like to share our additional perks of training, product relations and partnerships, as well as our sister business vet care. Once you have found your new companion we will follow up with all the perks that come along with adopting one of our dogs. We are here to support you through your companionship not just the adoption process. We love our dogs, and we love the people who love them. Type yes to know H2H is here to help you and be a part of your canine journey from beginning, middle and end.

Spay/Neuter Policy

As required by Missouri's Department of Agriculture regulations, adult dogs over 6 months of age must be spayed/neutered within 30 days of the dog being brought to our organization. Dogs over 6 months old will be spayed/neutered before being transferred to the adoptive home. Puppies under 6 months of age must be neutered by the time the puppy is 6 months old. Failure to adhere to these policies will result in forfeiting your rights to the adopted dog. Please initial if you agree to these terms.

Pregnancy Disclaimer

Home 2 Home Canine Orphanage sometimes welcomes breeder released pups into our care. Although extremely rare, if you adopt an adult dog and that dog begins to develop any signs/symptoms of possible pregnancy, it is your responsibility to report this to a Home 2 Home staff member immediately and allow the pup to be seen by our approved veterinarians. If a dog were to actually deliver puppies, these puppies belong to Home 2 Home Canine Orphanage and we must be notified immediately. Failure to adhere to these policies will result in the forfeiting of your rights to the adopted dog. If you agree to these terms, please initial.

*I have read and agree to the Terms and Conditions