Shar-Pei Rescue of Virginia Online Application

Shar-Pei Rescue Online Application

Adoption Policies

Shar-Pei Rescue of Virginia uses the following guidelines and policies when processing applications. We thank you in advance for your understanding of our requirements.

We adopt to homes in the United States east of the Mississippi. If you are not located in this area, please inquire before submitting an application. We limit our adoption area because we must travel to the applicant‘s residence for a home visit and arrange for transportation of the dog to the applicant‘s home. We do not ship our dogs.
We require that all animals in the home be spayed/neutered, up-to-date on vaccinations, and on heartworm preventative. We will contact your veterinarian to verify this information. Many veterinarians require permission to release information, so please let them know that we will be contacting them and provide the appropriate permission.

For additional details about our adoption process, please visit our FAQ page.

Application and Adoption Fees

Adopters, a non-refundable $10.00 application processing fee must be submitted with your application. This fee offsets application processing and costs associated with a Criminal History Check. Payment can be made via Paypal or check. Instructions will be provided on the application submission confirmation page. Please note that we cannot guarantee the availability of any dog on our website because we often have several applications being processed. If you are interested in only one specific dog, please inquire about the availability of the dog before applying.

There is an adoption fee of $275 for dogs under 7 years of age and $175 for dogs over 7. All dogs are spayed/neutered, up-to-date on vaccinations, and micro-chipped before leaving rescue. Adopters will also be given an “adoption kit”. Entropion surgery is also done upon vet recommendation. Before the average rescue dog enters its adoptive home, an average of $300 - $500 may have been spent for medical treatments & foster care. We care for each Pei as if it were our own pet.

* indicates required entry

Adoption/Foster Application

Date:

Applying for:* Adoption Foster

Do you understand that Shar-Pei Rescue of Virginia requires an adoption fee of $275 for dogs under 7 years of age and $175 for dogs over 7?* Yes No

Which dog(s) are you interested in?

Applicant Information

Applicant First Name:*

Applicant Last Name:*

Birth Date:*
(must be at least 18 years of age)

Drivers License # & State of Issue:*

Street Address:*

City:*

State:*

Zip Code:*

Home Phone:*

Cell Phone:

Email:*

Employer:

Position:

Work Phone:

May we contact you during work hours, if necessary? Yes No

Co-Applicant Information

Co-Applicant Name:

Relationship to Applicant:

Birth Date:

Drivers License # & State of Issue:

Street Address:
(If different from Applicant)

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Email:

Employer:

Position:

Work Phone:

May we contact you during work hours, if necessary? Yes No

Section 1

What, if anything, do you know about Shar-Pei? (Temperment, health, etc.)*

Why do you want to adopt a Shar-Pei (check all that apply)?* Companion Train for Competition Guard Dog Gift To Breed Personal Protection For Your Children

Do you rent or own your home?* Rent Own

What type of dwelling is it?* Single Family Home Townhouse Condo Apartment Duplex Mobile Home Live with parents

Are there any covenants (restrictions, size, type) that prevent you from having a particular pet?* Yes No

If yes, please explain:

Do you have permission from this property owner to have a dog?* Yes No

(Proof of ownership, or lease with pet clause will be required)

If renting, please provide your landlord's name, address and phone number:

How long have you lived at this residence?

If less than five years, please list all addresses for previous five years and dates of occupancy:

Do you have fencing (a totally enclosed, secure yard)?* Yes No

Please describe (type of material, height, size of yard)

Do you work? No Full-Time Part-Time More than one job

How many hours will this pet be alone per day?

Where will this pet be kept while you are away or at work?

During the day

At night

Is anyone home during the day? Yes No

Who?

How long?

Do you have children?* Yes No

Please list ages

Who will be responsible for the primary care of this animal?

We require that all animals adopted from us be spayed/neutered and that all other dogs and cats in the household be spayed/neutered. Do you have any questions or reservations about this policy?* Yes No

If yes, please explain:

Who will care for this animal while you are on vacation?

If you have to move, what will you do with this animal?*

Are you willing to take responsibility for this pet for the next 10 or more years, even if you have your first or more children, pets?* Yes No

For what reason(s) would you return the dog to rescue?* Move Birth of Child Divorce Expense None

It can cost up to and beyond $650/year=$55/month to care of a pet, taking into consideration the cost of veterinary care, food, licensing, boarding, etc...Is this affordable?* Yes No

What will you do if the pet gets sick, injured, or requires surgery?*

We require pets to be taken annually to the veterinarian for rabies, distemper, hepatitis, leptospirosis, Para influenza, and parvovirus inoculations, and be checked for parasites and heartworms. Will you be able to do so?* Yes No

How will you control fleas/ticks?

It is required that pets be kept on a heartworm preventative year round, will you be able to do so?* Yes No

Section 2

Please list all pets you own or have owned in the last five years:*
Name	Breed	Sex	Spayed/Neutered	Age	Where is it now?

Do you have a veterinarian?* Yes No

If yes, please fill in the name, address and phone #* (required if you have a vet)

Name of Vet

Name of Clinic

Address

Phone

Are all pets current on vaccinations?* Yes No N/A (no current pets)

If no, please explain:

If you have had to surrender a pet in the past, please explain*

If you have ever had a pet die at an early age or in an accident, please explain*

How do you plan to exercise the dog?

Do you plan to tie or chain the dog outside at anytime? Yes No

If yes, please explain:

How will you handle the following:

Excessive barking

Excessive chewing

House breaking

Are you willing to give this pet time to adapt to his new environment and family members (at least 30 days)? Yes No

Do you understand this animal may not be housebroken and are you willing to take the time to work with this animal? Yes No

How did you hear about Shar-Pei Rescue of VA, Inc.?

Section 3 - Foster Homes Only, Adopters Proceed to Section 4

Please explain why you would like to foster a Shar-Pei

Are you able to foster (check all that apply)? Sick Injured Healthy Nursing Mother & Pups Behavior/Temperment Problems

How many dogs can you foster at one time? 1 2 3 4 5 As many as necessary

Do you understand that most foster animals need daily medication, special feedings, veterinarian care and lots of love and attention. Can you provide the time necessary to care for this animal until adopted? Yes No

How long are you willing to take responsibility for this animal? 10-day quarantine 2-4 months 6 months - 1 year until adopted

Are you familiar with diagnosing basic canine symptoms of illness? Yes No

Section 4

Have you or someone in your family ever been accused, convicted, or fined for animal related neglect, abuse, violations, or penalties at your current or previous addresses?* Yes No

If yes, please explain:

(Under Virginia Code Section 3.1-796.96 et seq., we are required to verify this information)

By clicking the Submit button below, applicant acknowledges the following:

I ACKNOWLEDGE THAT ALL THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND CORRECT. I AGREE TO THE TERMS AND CONSIDERATIONS SET FORTH IN THE APPLICATION COVER LETTER. I UNDERSTAND THAT ANY MISREPRESENTATIONS OF FACT MAY RESULT IN THE REMOVAL OF ADOPTED/FOSTERED DOG FROM MY HOME BY SHAR-PEI RESCUE OF VA.

Payment Type

Select payment type for non-refundable $10.00 Application Fee* Paypal Check

Shar-Pei Rescue of VA, Inc.
PO Box 968, Barnegat Light, NJ 08006 • info@sharpeirescueofva.org • 609-494-0020
Preferred method of contact is email
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