MACSPRO Foster Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Option 1

Clear selection

Option 1

Clear selection

Personal Information

First Name *

Last Name *

Street Address *

State *

City *

State *

Zip Code *

Home Phone *

Include Area Code

Work Phone *

Include Area Code

Home Email *

Place of Employment *

Occupation/Position *

Currently Employed *

Full Time

Part Time

Other:

Vet Information

Vet's Name *

Vet's Phone *

Include area code

Vet's Street Address *

Vet's City *

Vet's State *

Vet's Zip Code *

Family Information

Adults Living in Household *

please include number and ages

Children Living in Household *

please include number and ages

Pets Currently Living in Household *

please include number and type

Pet(s) Names *

Are your dogs/cats up to date on vaccines? *

Yes

I have no dogs/cats

Are your dogs/cats spayed/neutered? *

Yes

I have no dogs/cats

If your dogs/cats are not up to date on vaccines or spayed/neutered, please explain why.

Home Situation *

(If renting, attach letter from landlord indicating pets are allowed)

Rent

Own

Living with Parents

How many years at current residence: *

Type of home. *

Do you live in (House/Townhouse/Apt/Duplex/Condo/Mobile Home)?

House

Townhouse

Apartment

Duplex

Condo

Mobile Home

Other:

Do you have a fenced yard? *

Yes

If you have a fence please describe the type of fence and height.

Average number of hours a day someone is home. *

How many hours will this dog be alone per day? *

Where will this dog be kept during the day? *

Where will the dog sleep at night? *

How will the dog be confined while outdoors? *

Do you plan to tie or chain the dog out at anytime? If so, please explain: *

If you go away for a few days, who will care for the dog? *

Are you willing to take care of this dog for the rest of his life (next 10 to 20 years)? *

Yes

Why do you want to foster this animal? *

Companion: Guard Dog: Gift: For Children: Other:

Companion

Guard Dog

Gift

For Children

Other:

Who will be responsible for this animal? *

Are you willing to give this dog time to adapt to his new environment and family members (at least 30 days)? *

Yes

Do you understand this animal may not be housebroken and are you willing to take the time to work with the animal? *

Yes

Have you ever given up an animal before, and if so, why? *

Previous experience with Shar-Pei: *

Are you interested in any particular Shar-Pei on the "Available" list? *

Include ID number.

Do You Have a Shar-Pei Preference? *

sex, color, coat, mouth, etc

Two References (Not Related)

Reference 1 Name *

Reference 1 Phone *

Reference 1 Email *

Reference 2 Name *

Reference 2 Phone *

Reference 2 Email *

Final Steps

How did you hear about MACSPRO? (please be specific) *

Are you interested in joining the Mid-Atlantic Chinese Shar-Pei Rescue Operation, Inc.? *

As a member of the Mid-Atlantic Chinese Shar-Pei Rescue Operation, Inc., you will receive our quarterly newsletter and support from our staff for any problem or question you may have about your Chinese Shar-Pei. A nominal membership fee is due.

Yes

I would like more information before I decide

Typing your Initials here to approve of the following: *

Placing our Shar-Pei in new homes is a responsibility we take very seriously. We reserve the right to refuse the adoption of an animal to a home that does not meet the standards of the Mid-Atlantic Chinese Shar-Pei Rescue Operation, Inc.. This includes the right to investigate new homes before and after an adoption is made, and remove the animal if it is not receiving proper care or has been mistreated. We request that you take into consideration the cost of food and health care as well as the time you have available to spend with your new companion. Consider the needs of the animal as well as your own. If you cannot provide a lifetime home for a pet, do not adopt one. Initial your approval here.

Applicant Signature *

By entering your name in the box below you certify that all information given to MACSPRO through this webform is true and complete to the best of your knowledge.

Applicant Agreement *

I certify the above to be true and complete to the best of my knowledge.

Required

Co Applicant Signature *

By entering your name in the box below you certify that all information given to MACSPRO through this webform is true and complete to the best of your knowledge.

Co Applicant Agreement *

I certify the above to be true and complete to the best of my knowledge.

Required

Would you like to be added to our email list? *

Please select "Yes" if you'd like to receive updates about MACSPRO via email.

Yes

I'm already on it

Today's Date *

YYYY

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms