Canadian Association for Shar-Pei Rescued

Instructions:  Copy and paste this application into an e-mail and send it to or mail to S. Palmay, RR#3, Mansfield, Ontario,  L0N 1M0

Name:  ______________________________

Street Address: ____________________

City/Prov. _________________________  Postal Code:____________

Phone:   ______________

E-mail:  ________________

What can you foster?   Sick _____  Injured _______  Healthy _________ Nursing Mothers /pups  _____________

Can you deal with behavioral/temperament problems?  Yes _____  No _____   If Yes please explain.

How many dogs can you foster at one time?  _______

How long are you willing to take responsibility for this foster dog?  ________________

Where do you live?   Single family Home ______  Apartment _____  Mobile Home _____  Other  _____

Do you rent or own your own home?   __________________

Any covenants or restrictions that prevent you from having a pet?      Yes _____     No  _____  If yes please explain. 

Do you have a totally enclosed, secure yard?   _______________

Describe the fence- height, wood or chain link and area size.  ___________________

How do you plan on exercising the dog?  ___________________________________

Can we contact your vet?    Yes______   No  _______

Vet Name:  ____________________________

Vet Phone:  _____________________________

I acknowledge that all the information contained on this form is true and correct.

I understand that any misrepresentations of fact may result in the removal of the foster dog from my home.

Agree:  ___________  Do Not Agree:  ___________

Signed:   ____________________    Date: ______________

CASPR Representative:    _______________________   Date:  ____________.