Guardian Home Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Thank you for your interest in our Guardian Home Program. This application will help us get to know you and your home better.Name *FirstLastAddress *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhone *Email *How far do you I've from Stockton, Missouri? *Occupations (s) *Work Schedule(s) *How many adults link in the home? How many children, please list ages. *Does anyone in the household have dog allergies? *YesNoDo you rent or own your home? *OwnRentIf renting we will require landlord approval in writing.Do you have a fenced yard? *Yes - PhysicalYes - InvisibleNoIf fenced, what type and height? *Is the yard fully secure with no gaps or escape points? *YesNoWhere will the dog stay during the day? *Where will the dog sleep at night? *Will the dog primarily live indoors? *YesNoHave you owned a dog before? *YesNoIf yes, what breeds? *Have you ever surrendered a dog to a shelter or rehomed one? *YesNoIf yes, please explain. *Current pets in the home (breed, age, spayed/neutered): * responsible a During Are your current pets up to date on vaccinations? *YesNoPlease confirm you understand the following: ☐ The puppy is placed at no purchase cost, but Breeder retains full ownership until retirement. ☐ Females will typically have 3–4 litters. ☐ The dog will come to Breeder’s home approximately 7–10 days prior to her due date and remain until puppies are weaned. ☐ Guardian is responsible for routine vet care, vaccinations, grooming, heartworm prevention, and flea/tick prevention. ☐ During heat cycles and pregnancy, only Frontline Gold topical flea/tick prevention is permitted. ☐ The dog must remain on Royal Canin dog food during her breeding career. ☐ You must notify Breeder immediately upon signs of heat. ☐ You must live within one hour of Stockton, Missouri. *Yes, I agree and UnderstandWhy are you interested in being a Guardian Home?How do you feel about temporary separations during breeding and whelping?Are you comfortable transporting the dog for breeding-related appointments? *YesNoWho will be primarily responsible for the dog’s daily care?How many hours per day would the dog typically be alone?Guardian families are responsible for all routine veterinary care, vaccinations, monthly preventatives, and grooming expenses unrelated to breeding.Are you financially prepared to assume these responsibilities? *YesNoDo you plan to move within the next 5 years? *YesNoIf moving please explain.Is there anything else you would like us to know?I certify that the information provided is accurate and complete.Signature Clear SignatureDate / TimeDateTimeSubmit