Application Form MAKE A DONATION Please enable JavaScript in your browser to complete this form.Name *Email *Phone *Do you own or rent?OwnRentLand lord's Name & PhoneDo you live in a ...HouseTown HouseApartmentHow long?Are pets allowed?YesNoIs your yard fenced?YesNoWill pet be kept ...InsideOutsideTiedVeterinarian's Name & PhoneDo you have other pets?YesNoPlease list breed, sex, age, number, species, and whether spayed or neuteredDo you have children?YesNoPlease give number & agesIs someone home all day?YesNoWorkFTPTRetiredHours of workReference 1: Name, Address, PhoneReference 2: Name, Address, PhoneShar-Pei Preferred SexMaleFemaleDoes not matterColorBlackRedFawnCreamChocolateSableApricotDoes not matterWhy do you want a Chinese Shar-Pei from the rescue?NameSubmit
