Adoption Application

Thank you for your interest in adopting a rescue Chinese Shar-Pei. The dogs available for adoption are screened for temperament and health. All dogs have been given their vaccinations, started on heartworm and flea preventative and 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 adoption is a good candidate for a new family. We want our dogs and our adoption families to be happy with the placement.

The following application is very important to helping us make the perfect match between dog and new “parent.” We reserve the right, at our sole discretion, to turn down an application. By submitting this application, you are giving us permission to check the references listed and you are demonstrating your sincere interest in pursuing the adoption of a Shar-Pei from Florida Shar-Pei Rescue.

Since we are a 501c3 not for profit rescue your adoption donation is tax deductible
and a reciept will be provided with adoption paperwork.

Please answer ALL questions on this application
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED

ALL FIELDS ARE REQUIRED

Applicant First Name :
Applicant Last Name :
Co-Applicant First Name :
Co-Applicant Last Name :
Street Address :
Address 2 :
City :
State :
Zip Code :
Your Email :
Phone Number :
Additional Phone :

Employment Information

Applicant’s Employer : (If not employed please explain)
Position :
Company Phone :
Co-Applicant’s Employer : (If Applicable. If not employed please explain)
Co-Applicant’s Position :
Co-Applicant’s Work Phone :
Are you interested in doing other types of volunteering?

Please answer the following questions completely.

How did you hear about Florida SharPei Rescue?
What kind of experience do you have with the breed or dog ownership in general?
What do you know about Chinese SharPei? (Temperament, health, etc.)
Why do you want to adopt a Chinese SharPei? Please give all reasons that apply (companion, guard dog, gift, to breed, personal protection, for children, other).

Please describe your living situation, so that we may find a good fit for each Pei:

What type of home do you currently live in?
Do you own or rent?
If you rent, please provide us with your landlord's name and phone number. Please note that we will contact your landlord. (Required for renters)
How long have you lived at the above address?
Do you have a fenced yard?
 Yes No
If yes, what kind of fencing do you have?
If not, how do you plan to exercise the dog and provide routine potty breaks?
Do you have a crate or intend to use a crate for safety purposes?
 Yes No
Are there children or other adults in home? Please list the names and ages of all persons living in your household.
If other adults in the household, do they all approve of getting a dog?
 Yes No
Are there other pets in the home?
 Yes No
If yes, please describe and advise if current pet is less tolerant of dog of opposite gender or particular behavior such as very active/playful.
If you move to a location that does not accept dogs, what will you do? *
Do you have a plan for care of your dog should you need to be away from home for an extended period?
Are you financially prepared to provide for quality food and monthly flea-tick/heartworm preventative? (Note that Rescue incurs cost for any needed veterinary care.)
Have you owned a Chinese SharPei in the past?
 Yes No
Do you understand this dog will stay with you for the rest of his life?
 Yes No
If you have owned animals in the past, what happened to those animals?
Do you take your pet to a vet annually?
 Yes No
Are you familiar with heartworm preventative and the vaccinations that are necessary?
 Yes No
Are your current pets current on their vaccinations and heartworm preventative?
 Yes No
If you have animals in the house that are not spayed/neutered, fully vaccinated, and on heartworm/flea prevention medicine please explain why.
Current and/or Past Veterinarian Name (We will call them for a reference.):
Veterinarian Phone :
We require that all animals adopted from us be spayed/neutered. If you have any questions/concerns/reservations about this policy, please explain below.
Are you prepared for the possibility of more than routine vet bills and care of the dog?
 Yes No
Where do you plan on keeping your Chinese Shar-Pei the MAJORITY of the time?
Where will your Chinese Shar-Pei sleep at night?
What will you do with your Chinese Shar-Pei when there is no one at home?
What will you do if your Chinese Shar-Pei exhibits bad behavior? ie...being destructive, soiling the house, barking, etc.
Do you understand that this dog may not be housebroken and are you willing to take the time to properly housetrain?
Do you understand that it may take this dog time (at least 30 days) to adapt to his new environment and family?
What are your preferences for your adopted dog? ie. age, sex, color, etc. Did you see a particular dog on our website that you are interested in? If so, please indicate.
Would you be comfortable adopting or fostering a dog with temporary medical needs? For example, caring for a dog being treated for demodex, yeast, ear infection, or immediately after eye surgery? (Note that most dogs need more love than medical care, but the Rescue wants everyone to be comfortable with his/her role.
Would you be willing to adopt or foster a dog with a medical condition? (allergies, thyroid problem, etc.)
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?
Please give two professional references.
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.)
A volunteer will coordinate with you for a meeting and/or home visit. How should we contact you?

Foster and Volunteer Agreement

By submitting this form you acknowledge and agree to the terms below:
Foster Home agent or Volunteer being of lawful age, do now release, acquit and forever discharge Florida Chinese Shar-Pei Rescue, its Agents and Assigns, from any and all actions, claims, demands or damages accruing to me resulting from any known or unknown injury, loss or damage, sustained by me as a result of acting as a Florida Chinese Shar-Pei Rescue foster agent or volunteer. I affirm that I have not been convicted of any crime involving the mistreatment, neglect or abuse of any animal. 


Adoption Agreement

By submitting this form you acknowledge and agree to the terms below:
Adoptee being of lawful age, do now release, acquit and forever discharge Florida Shar-Pei Rescue, its Agents and Assigns, from any and all actions, claims, demands or damages accruing to me resulting from any known or unknown injury, loss or damage, sustained by me as a result of acting as a Florida Shar-Pei Rescue adopter.

 

I ACKNOWLEDGE THAT ALL THE INFORMATION CONTAINED ON THIS FORM IS TRUE AND CORRECT. I UNDERSTAND THAT ANY MISREPRESENTATIONS OF FACTS MAY RESULT IN THE REMOVAL OF THE DOG FROM MY HOME.

Please check this box to acknowledge above.
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