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Thank you for your interest in adopting a rescue Chinese Shar Pei. The dogs available for adoption are screened for temperament and health. Although the dog’s background is generally unknown we have done our best to assure a well-tempered, healthy dog. All dog’s have been given their vaccinations, and unless very young, have been spayed or neutered. Although, we cannot guarantee that there are no problems with the dogs in rescue, we have done our very best to assure that each dog in the program is a good candidate for a new family. We want our dogs and our adopting families to be happy with the placement. The following application is
very important to helping us make the right match between dog and new
“parent”. We, therefore, reserve the right, at our sole discretion, to
turn down an application. By
submitting this application whether my mail, in person or via the
Internet, you are giving us permission to check the references listed
and demonstrating your sincere interest in pursing the adoption of a dog
from our rescue program. Name: Street Address: City: Province: Postal Code:: Home Phone: Work Phone Name of Co-Applicant: Relationship: (Circle choice) Spouse Parent Child Roommate Other E Mail address: (Required if applying via the internet.) Applicant’s Employer: Position: Phone: Co-Applicant’s employer: Position: Phone: 1) How did you hear about our Rescue? 2) What do you know about the breed (temperament, health, etc.)? 3) Why do you want to adopt a Chinese Shar Pei? Please give all the reasons that apply. (companion, guard dog, gift, to breed, personal protection, for children, other. 4) Do you have a preference in coat, color, sex or age? If yes please check. ______ Young. (Puppy to age 2) ______ Adult. (3-7 years old) ______ Veteran. (7 years of older) 5) Do you own or own your own home: 6) How long have you lived at the above address? 7) What type of home do you live in? Apartment ____ House _____ Duplex _____ Mobile Home _____ Condo ______ Other ______ 8) If you rent, please provide us with the landlord’s name and
phone number. Please 9) How long have you lived at this address? _____________ 10) Are there any covenants (restrictions, size, number, type) that prevent you from having a particular pet? If yes please explain. _____________________________________________ 11) Who will be responsible for the care of this dog? ______________________ 12) If you have children living in your home or that visit on a regular basis, please indicate their ages and sex. 13) How many hours will your dog be alone per day? ______________ 14) Who will care for this dog while you are on vacation? ________________ 15) If you have to move what will you do with your dog? ______________________ 16) Are you willing to take responsibility for this dog for the next 10 or more years? _____ Even if you have your first or more children or pets? _________ 17) Will this dog be taken annually to the veterinarian for rabies, distemper, Hepatitis, leptospirosis, parinfluenza and parvovirius inoculations and bechecked for parasites and heartworms? Yes______ No ______ 18) How will you control fleas and ticks? ________________________ 19) Will this dog be kept on heartworm control year round? Yes ____ No ______ 20) Have you ever owned a Chinese Shar Pei? ___________ 21) If you have owned animals in the past, what happened to those animals? 22) If you have other animals, please fill out the sections below. Breed/Type Age Spayed or Neutered Breed/Type Age Spayed or Neutered Breed/Type Age Spayed or Neutered Breed/Type Age Spayed or Neutereed 23) Please provide the name and address of your veterinarian. We will call them for a reference. 24) Do you have a fenced yard? 25) What kind of fencing do you have? 26) If you do not have a fenced yard how will your Shar Pei be exercised? 27) Where do you plan on keeping your Shar Pei the MAJORITY of the time? 28) Where will your dog sleep at night? 29) What will you do with your dog when there is no one at home? 30) What will you do if your dog exhibits bad behavior? Ie..being destructive, Soiling the house, barking, etc? 31) Do you understand that this dog may not be housebroken, and are you willing to take the time to properly housetrain? 32) Do you understand that it may take this dog time (at least 30
days) to adapt to his 33) Would you be willing to adopt a dog with a medical condition (allergies, thyroid Problem. Etc). Note.. We will not adopt out a dog with a major medical problem such as cancer. 34) Would you be willing to adopt a dog with a behavior problem (chewing, Separation anxiety, fear of thunderstorms, not housebroken, etc.) Note We will not adopt a dog that is aggressive or has bitten before – under any circumstances. 35) Please write any additional comments below. Use this space to also indicate Any health or behavior problems that you could NOT handle. (dog aggression, cat aggression, daily medication, etc. 36) Please give us names and phone numbers of three people (non family) who we can call for references. |