Form
Small Town Dachshunds Application
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Have you had a Dachshund before?
Please Select
Yes
No
Who will be the primary caregiver?
How long will the puppy be left alone on a daily basis?
Any allergies to dogs?
Please Select
Yes
No
Are there any children in the home?
Please Select
Yes
No
Do you live in a house or an apartment?
Please Select
House
Apartment
Is there a fenced yard?
Please Select
Yes
N0
Do you have dogs now? If so, which breeds and ages?
Do you have a training plan for the puppy?
Dachshunds are one of the hardest breeds to house train. Are you aware of this?
Are you able to pick the puppy up, or do you need transportation or delivery?
Will you be able to pick the puppy up on or around 8 weeks old?
Please Select
Yes
No
Will this dog be bred in the future?
Please Select
Yes
No
Maybe sometime down the road
Do you understand that this puppy is a pet only, and not to be bred?
YES
Veterinarian Reference
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Non Family Member Reference
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How did you hear about us?
Where did you find us?
Please Select
Facebook
Craigslist
Internet
Other Platform
Who referred you to us? If applicable.
Submit
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