Adoption Application
Please fill out IN FULL our adoption application. If the form is not complete, it will not be processed. A representative will be in touch with you soon. Remember, we're all volunteers fitting rescue into already busy lives. If you do not hear from someone within 2-3 weeks, please email info@wienerdogrescue.com to find out the status of your application. NOTE: Our form is not working. Please cut and paste the questionnaire into an email message and send the information to apps@wienerdogrescue.com. To cut and paste the application, complete the following steps: 1. Hold down your mouse button as you scroll over the entire application to select the text you want to copy. 2. While the text is selected, press and hold down the Ctrl key and press C. The text is copied to your clipboard. 3. Open your email program and create a new message. Click in the area where you would usually enter the text of a message. Press and hold the Ctrl key and press V. The application will be pasted into your email. 4. Fill in the empty fields. When finished send to the email address above.
Adoption Application
Today’s date______________________ Name___________________________ Address________________________________________________________ Home telephone___________________ Work telephone___________________ E-mail__________________________ Reference #1: Please provide the name, location, and telephone number of your veterinarian (required for all applicants who own or have owned a companion animal).
Reference #2: Please provide the name, location, and telephone number of someone who knows you well and is not a personal friend—e.g., employer, clergy, associate in an organization, etc.
Reference #3: You may provide additional references. Please be sure to include a telephone number for each.
Do you have preferences for a certain type of dachshund? If so, please specify: Color ___________________ Coat ___________________ Size ____________________ Gender__________________ Age range _______________ If you have indicated preferences, please explain them (e.g., why you prefer a male to a female).
If you have indicated preferences, are you flexible? Do you have a second choice?
Are you willing to adopt a dachshund mix? _____Yes _____No Are you willing to adopt a dachshund that…
Is not completely housebroken? _____Yes _____No Is not reliable with children? _____Yes _____No Has a physical deformity or handicap? _____Yes _____No Requires ongoing medication for a medical condition? _____Yes _____No Do you own any pets? If so, please list each pet by name, species, breed, and age. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ If you own dogs, how would you describe their personalities? Dominant, submissive, playful, aloof, etc.?
If you own cats, have they been exposed to dogs? How do they react?
Have all the animals listed above been spayed or neutered? _____Yes _____No If no, what are the circumstances?
Have you ever owned a dog who is no longer living with you? _____Yes _____No If yes, what happened to the dog? Please provide a complete answer (e.g., if a dog died, what was the cause of death and age of the dog?)
Please describe what you know or assume about the special needs of rescue dachshunds.
What would you say are the best dachshund characteristics? The worst?
What routine medical treatments/preventives do you consider necessary for a dog?
About how much would you expect to spend annually on medical care for a healthy dog?
Please list the name, age, and relationship of all people living with you. ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________
How often, on average, do other people visit your home?
Explain briefly how you will introduce visitors to your dachshund.
How have you taught your children (or how would you teach visiting children) to interact with a dog?
Who will be the primary caregiver for this dog? Who will care for the dog when the primary caregiver is away—at work or on vacation?
How many hours will the dog be left at home alone during the day? Where will the dog be kept during those hours?
Do you own your home or rent? _____Own _____Rent If you rent, is your landlord agreeable to your having a dog? _____Yes _____No Please provide name and telephone number of landlord:
What is your opinion of obedience training? Have you ever done it with one of your dogs?
Where will the dog sleep?
What do you intend to feed your dog?
The information provided in this application is true to the best of my knowledge as of the date of the application.
____________________________________ Signature |