First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone

Alt Email

When is the best time to contact you?

Do you work?*

Employer:

Co-Applicant Name (First and Last)

Co-Applicant Works:

Co-Applicant Employer:

How did you hear of Dachshund Rescue of Houston

Have you or the co-applicant ever applied to Dachshund Rescue of Houston before?*

Have you applied with any other rescue*
Choose one: Yes No

How many people (including you) live in your home?*
Choose one: 1 2 3 4 5 6 7 8 9 10+

Please list the ages of the people living in your household.*

Please list any step-children, grandchildren, cousins, friends' children and their ages(s), that visit regularly on weekends or vacations.

Do you live in a:*

If other, please describe:

Do you have stairs inside or outside your home?*

How long have you lived at this residence?*

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

Is the fenced area attached to your residence?

What type of fence
Choose one: Privacy Chain Link Invisible Other

What is the height of the fence

Do you have a dog door?*

Do you have a pool?*

Do you own or rent your home*
Choose one: Rent Own

If you rent, please enter your landlord's name and phone number

If you rent, do you have permission from your landlord to have a pet?

If you rent, have you paid your pet deposit?

If you rent and a deposit is required, please enter the amount of the pet deposit. Specify whether it is a one-time fee for any numbers of animals, or if it is a per-animal fee.

Why do you want to adopt a Dachshund

If there are other reasons, please list them below.

Do you currently have any pets? *

For all pets in the house, please list: Pet Name, Type of Pet & Breed, Age, Sex, Spayed or Neutered:

Have you had any pets besides the ones listed above?*

What happened to those pets? Why are they no longer with you?

Please list the names and phone numbers of your pets' veterinarians (Name of Vet or Clinic, Phone Number, Pets who were cared for by this vet.)*

Do we have your permission to check your vet records? (To expedite the processing of your application, please give your veterinarians permission to release information to Dachshund Rescue of Houston.)*

Where do you purchase Heartworm Preventative? If on-line, please provide the website address. *

If you have not had a pet as an adult or do not have a current vet reference, please provide the name and phone number of the vet you are going to use, and explain why you will choose that vet.

Have you ever given up a pet? If yes, please explain

Who in the household will care for the pet*

Please explain in detail your idea of the Dachshund who would fit best into your home. *

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

How much time will the animal spend alone during the day*

Where will the animal sleep*

Where will the animal be kept when you are not home (Running Errands / At Work)?*

Where will the pet be kept while you are on vacation?*

Describe how you will housetrain the dog, and what you will do if it pees or poops in the house:*

Please describe a typical day's activities for your new pet(s). What will be their daily routine? *

Please explain how and where will you exercise your dachshund? *

How do you feel about walking a rescued dachshund WITHOUT a leash?*

How often do you expect a healthy dachshund to have accidents in the house?

Will you return this dog if you have difficulty housetraining him/her?*

For what reasons would you feel compelled to give up your dachshund or any other animal?

Please explain all the reasons you checked above (an honest, DETAILED answer is best, so we can find the BEST dog for your situation). *

If the dachshund cannot remain in your home with your family, will you notify Dachshund Rescue of Houston?*

Preferred Sex:

Preferred Age:

Preferred Size:

Preferred Coat:

Preferred Color

Would you consider adopting a special needs dog? *

Would you consider adopting a dog that submissively pees?*

Would you consider adopting a dog that MUST sleep in bed with you?*

Would you consider adopting a senior dog?*

Would you consider adopting a dog unreliable with small children? *

Would you consider adopting a dog needing housetraining?*

Would you consider adopting a dog needing daily medications?*

Would you consider adopting a dachshund "mixed-breed"? *

Would you consider adopting a pair of dachshunds?*

Please add any other information you think might be helpful to us in evaluating your application.

I certify that the above information is true and understand that false information may result in an application denial and/or nullification of any adoption. By entering your name below you signify that you have filed this application and understand the content contained within. Enter your name and date:*