Application to Adopt

Please provide the following contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

How long have you lived at this address?

Choose one of the following options:

Single family dwelling Duplex Townhouse Apartment

If rented please provide the landlord's contact info:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Do any children live in this house?

Yes
No

If yes, please list ages:

Does anyone in your family have pet allergies?

Yes No

If yes, please explain:

Do you have any other animals?

Yes No

If yes, what type, breed, age, sex:

If cats, are they altered?

Yes No

If dogs, are they altered?

Yes No

What are the approximate dimensions of your yard?

What type of fencing do you have?

Wood Chain Link Block Farm Fencing Other None

How high is the fence?

Is someone usually home during the day?

Yes No

What hours would the dog be left unattended?

Will the dog be kept:

Inside Outside Both

If both, please explain and also comment on where in the house the dog will live:

What is your main reason for wanting a dog?

Companion Watch Dog Child's Pet Other

Why are you interested in a Chinese Shar-pei?

Do you have any preference in sex, colour or age?

Would you consider a special needs shar-pei?

Yes No

Would you like to be placed on a waiting list to adopt?

Yes No

Would you like to foster?

Yes No

Describe what characteristics you would like, such as behaviour and health:

We require 2 professional references (one should be a vet if you have other animals):

Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL

Second professional reference:

Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL

Where did you learn about TnT Sharpei Rescue?

Where will your dog be kept when you go on vacation?

Please enter the date of this application: