Online Adoption Application

Applicant & Family Information

	Primany Applicant	Co-Applicant
First Name:
Last Name:
Do you Work?:	Yes, Full-time Yes, Part-time No, I'm retired No	Yes, Full-time Yes, Part-time No, I'm retired No
Place of Employment:

How did you hear about Dachshund Rescue of Houston?:
Have you (or the co-applicant) ever applied to Dachshund Rescue before? Yes No
Email:
Address: Apt No:
City:   State: Zip:
Home Phone:
Work Phone:
Cell/Mobile Phone:
Best Time to Contact:
How many people are living in the home:   Ages:
List any step-children, grandchildren, cousins, friends' children and their ages(s), that visit regularly on weekends or vacations:

Housing Information
Do you live in a: House Townhouse/Condo Apartment Other
                        If Other, please describe:
Do you have stairs inside (or outside) your residence?: Yes No
How long have you lived at your residence?:
What kind of fence do you have and what areas are enclosed?:

Is the fenced area attached to your residence?: Yes No N/A
Do you have a dog door?: Yes No
Do you have a pool?: Yes No
Do you : Own Rent

If you rent:

            Do you have the permission of your landlord to have a pet: Yes No
            Have you paid your pet deposit? Yes No             Amount paid:
            Landlord's Contact Info (phone MUST be provided):
            Name:
            Phone:

Dachshund Questions

Why do you want to adopt a dachshund?:

Companion for Self Guard Dog Child's Companion Companion for Current Pet
To Teach Your Child How to be Responsible Gift Personal Protection Other
If Other, please explain:

Please explain in detail your idea of the Dachshund who would fit best into your home.
Elaborate on the reasons you want a Dachshund and tell us what your idea of the "perfect pet" is for your family.:

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

House Training Problems Doesn't get along with current pets Size (too big/small)
Moving Unreliable with Children Children no longer living at home
New Baby in Family Divorce Digs holes in your yard
Destructive in home or yard Aggressive towards Strangers Barks too much
Overly shy in public and timid around strangers Establishes dominance over your current pet
Jumps on Furniture Escape Artist Not Enough Time for Pet
Runs out front door Kills the cat, bird, hampster (etc.) Medical Expenses Other None

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?: Yes No

Pet Care Questions
Who will be responsible for the care of this pet?:
How many hours per day will the pet be left alone?:
Please describe the area where the pet will be kept during the day when you are not at home? Be Specific:

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

Which room do you expect your new pet to sleep in?:

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

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

How do you feel about training a rescued dachshund to walk beside you without a leash?:

Please explain how you will housetrain your dog, and what will you do if it pees or poops in the house?:
Since I know that NONE of your dogs are 100% housetrained, I will housetrain my new dog by...

After living in a stable home environment for 1 year,
how often do you expect a spoiled, stubborn, quirky,
HEALTHY dachshund to have accidents in the house?

Once a week Once a month Once a year When they are sick When it is cold outside
When it rains When they are mad at you When they feel like it Never

How long do you expect it to take to housetrain your new dog (days/weeks/months)?:

Will you return this dog if you have difficulty housetraining it?: Yes No

Pet Vet Care Questions
Do you currently own any pets?: Yes No

Name	Type of Pet & Breed	Age	Sex	Spayed or Neutered?
				Yes No
				Yes No
				Yes No
				Yes No
				Yes No
				Yes No

Have you owned any pets besides the ones listed above?: Yes No

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

Name and phone number of the veterinarians you use(d) for ALL of these animals (phone MUST be provided):

Name of Vet or Clinic	Phone Number	Names of Animals that were cared for by this vet

Do we have your permission to check your vet records?: Yes No

IF, you have not owned a pet as an adult (or do not have a current vet reference), please tell us:

What types of services and products will your vet provide you with? How often do you envision visiting the vet?:

Name of the veterinarian you plan to use:
Phone number of veterinarian you plan to use:
Your reason for using this veterinarian:

Rescued Dachshund Preferences
What is the name of the dachshund(s) you are interested in:

Preferred sex: Female Male No Pref
Preferred size: Mini (less than 12 lbs) Tweenie (13 to 17 lbs) Standard (greater than 18 lbs) No Pref
Preferred age: Puppy Young adult Adult Senior No Pref
Preferred color: Red Black & Tan Other No Pref
Preferred coat: Smooth Wire Long Hair No pref

Would you consider adopting a special needs dog?:	Yes No
Would you consider adopting a dog that submissively pees:	Yes No
Would you consider adopting a dog that MUST sleep in bed with you?:	Yes No
Would you consider adopting a senior dog?:	Yes No
Would you consider adopting a dog unreliable with small children?:	Yes No
Would you consider adopting a dog needing housetraining:	Yes No
Would you consider adopting a dog needing daily medications:	Yes No
Would you consider adopting a dachshund "mixed-breed"?:	Yes No
Would you consider adopting a pair of dachshunds:	Yes No

Have you applied with other rescue groups? Is so, please list below:


Please feel free to add any other information that you think might be helpful to us in evaluating your application:




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Thank you for taking the time to fill out our application. We know it is lengthy,
but we care very deeply about our doxie babies and want to make sure they go to the BEST homes.
We appreciate your interest in our dachshunds.

We are an all volunteer organization and have our own FULL-TIME EMPLOYMENT;
we will respond to your application as quickly as possible, but it could take up to TEN DAYS.
If you have not heard from us in ten days, please follow-up via e-mail at that time.
Otherwise, please be patient. Thank you!!

Adoption fees effective January 14, 2010 are $250 per dog or $150 for one of our seniors.

**Submission of an application DOES NOT guarantee adoption of a dog through Dachshund Rescue of Houston**