Dog Adoption Application

Dachshund Rescue of Ohio, Inc. Adoption Application

wildwienerranch@live.com
WE ONLY ADOPT TO HOMES IN OHIO WITH A PHYSICALLY FENCED IN YARD
Date of Application*

MonthDayYear
Name*
First & Last Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Age of Applicant*
E-mail*
Home Phone*

Area CodePhone Number
Cell Phone*

Area CodePhone Number
Residence:*

HouseCondominiumOther
Own or Rent?*

OwnRent
Name of dog(s) you are interested in*
Do you have a yard?*

YesNo
Is the yard fenced? (required)*

YesNo
Type of fence and height*
Do you have a pool?*

NoYes, in-groundYes, above-ground
Number of people who live in your home and their ages*
Does anyone in your home smoke?*

YesNo
Have you owned any dogs in the last ten years?*

YesNo
If you owned dogs that are no longer with you, what happened to them?*
Have you ever owned a Dachshund?*

YesNo
Why do you want to adopt a rescue Dachshund?*
Where will the dog sleep at night?*
Do you currently have any other pets?*

YesNo
Describe the age, weight, and breed of any other pet(s) living with you:*
If you have other pets, are they altered (neutered/spayed)?*

YesNo
Who will be responsible for feeding, training and housebreaking the dog?*
What type of food to you feed your dog?*
Do you work outside the home?*

YesNoOne applicant is home/works from home
How many hours on average will the dog be alone?*
Where will the dog be kept during the day?*
Where will the dog be kept when no one is home?*
Where will the dog stay during vacation and/or business trips?*
If your home has stairs, how many stairs, and explain*
Are you familiar with the necessary annual shots, as well as heartworm/flea medication?*

YesNo
How much do you feel you can reasonably afford and would be willing to spend on your dog per year (for things like veterinary care, licensing, ID tag, food, toys, crate, other supplies, training, pet sitting, etc)? *
Personal Reference*
Name, address, phone number, e-mail
Veterinarian reference (please call your vet and give permission to release information to us)*
Vet name, address, phone number, e-mail
The information I have provided is true to the best of my knowledge. Typing your name serves as your personal signature.*
Should be Empty:

Dachshund Rescue of Ohio, Inc. Adoption Application

WE ONLY ADOPT TO HOMES IN OHIO WITH A PHYSICALLY FENCED IN YARD