LIVE LOVE RESCUE ADOPTION APPLICATION (Online form available at

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LIVE LOVE RESCUE ADOPTION APPLICATION (Online form available at www.liveloverescueohio.com/adoption-form.html) Please fill out this form to adopt one of our dogs. Applications are processed in the order we receive them. Please allow us 3-5 days to get back to you. If you do not hear from us, feel free to message us at info@liveloverescueohio.com to inquire about the status of your application and a volunteer will get back with you. Dog's name I am interested in adopting: I understand part of the legally binding adoption contract states that I cannot, for the life of the dog, rehome it or surrender it to anyone other than Live Love Rescue. Please call me to discuss Name: First Address Line 1 Line 2 City State Zip Code Please note that we can no longer adopt out of Ohio as we are a small, all volunteer rescue run solely on donations from private individuals. Additional Owner Name: First Phone Number ( ) - Other Phone Number ( Email: How did you hear about Live Love Rescue? www.liveloverescueohio.com Facebook Petfinder Rescue Me Other website: Referral from Shelter/Kennel Friend I saw you at an Event I saw you on Fox8 News Other, please describe:

Choose One I own my home I rent Other arrangements If renting, are dogs allowed and is pet deposit paid?, I will obtain a letter of permission from my landlord, it is included on my lease Choose One House Apartment Condo Mobile Home Farm Other: Do you have a safe, enclosed fenced yard? If you have a fence, please describe the type (height, size & style, chain link, privacy, invisible, pen, etc) : If no fence, what arrangements do you have for the dog's exercise and toilet duties? Please describe the typical feel of your home environment, think of it from a dog's point of view (Check all that apply) Calm Chaotic Quiet Loud Bright Dark High Traffic Low Traffic Open Crowded Are certain breeds banned by your homeowner's insurance, city, or landlord? Unknown Page 2

Number of people in household (CIRCLE) : 1 2 3 4 5 or more Ages of children in household or who visit often: Are the children good with animals? Are you or anyone in your household allergic to dogs? Unknown Occupation: Are you prepared for an extended adjustment period for your new dog? This can last for anywhere from 2 hours to 2 months or more. Please ask if you are unsure what this period entails. Please discuss with me. I agree to a home visit by LLR before I adopt: I breed or sell animals or plan to in the future: I have a pet (any kind) in my home that I am currently attempting to rehome Amount of time you will spend with dog? Amount of time dog will be alone: Do you currently live with other pets? Have these pets lived with other dogs before? Page 3

Name, Species, and Breed of Pet #1 Age and Sex of Pet #1 Is Pet #1 Spayed/Neutered? Is Pet #1 current on vaccines, heartworm, and flea preventative (if it applies) Does not apply, not a cat or dog Does Pet #1 live Inside or Outside? Inside Outside Please describe Pet #1's personality and any other info that would be helpful: Name, Species, and Breed of Pet #2 Age and Sex of Pet #2 Is Pet #2 Spayed/Neutered? Is Pet #2 current on vaccines, heartworm and flea and tick preventative (If it applies)? Does not apply, not a dog or cat Does Pet #2 live Inside or Outside? Inside Outside Please describe Pet #2's personality and another other info you feel would be helpful Please include any other pets you have and the same information as requested above in this space or on the back: Page 4

Current Vet's Name (current or planned to use if no current pets) Address Line 1 Line 2 City State Zip Code How long have you been a Client? Vet Phone Number ( Personal Reference #1 First Name: Relationship Phone Number - - Good time to call? Personal Reference #2 First Name: Relationship Phone Number - - Good time to call? Any info we should know about your family/home or ability to be a responsible pet owner? Thank you for taking the time to fill out our foster application. By signing this application, you are giving your vet (listed above) permission to discuss you and your pet's records with Live Love Rescue. Yes I authorize the above vet/clinic to disclose any information about me or my pets to Live Love Rescue. This information will be used in evaluating my suitability for adopting or fostering a pet from Live Love Rescue. (Owner #1) (Owner #2) Date: Date: Please scan and email completed form to: apps(d,liveloverescueohio.com Snail Mail to: Live Love Rescue, 4331 Redding Rd, Cleveland, OH 44109 Page 5