Dachshund Rescue of Ohio, Inc. Adoption Application
wildwienerranch@live.com
Date of Application
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Month
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Day
Year
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Name
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First & Last Name
Address
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Street Address
Street Address Line 2
City
State
Zip Code
Age of Applicant
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E-mail
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Home Phone
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Area Code
Phone Number
Cell Phone
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Area Code
Phone Number
Residence:
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House
Condominium
Other
Own or Rent?
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Own
Rent
Name of dog(s) you are interested in
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Do you have a yard?
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Yes
No
Is the yard fenced? (required)
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Yes
No
Type of fence and height
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Do you have a pool?
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No
Yes, in-ground
Yes, above-ground
Number of people who live in your home and their ages
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Does anyone in your home smoke?
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Yes
No
Have you owned any dogs in the last ten years?
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Yes
No
If you owned dogs that are no longer with you, what happened to them?
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Have you ever owned a Dachshund?
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Yes
No
Why do you want to adopt a rescue Dachshund?
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Where will the dog sleep at night?
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Do you currently have any other pets?
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Yes
No
Describe other pets currently living with you
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If you have other pets, are they altered (neutered/spayed)?
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Yes
No
Who will be responsible for feeding, training and housebreaking the dog?
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What type of food to you feed your dog?
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Do you work outside the home?
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Yes
No
One applicant is home/works from home
How many hours on average will the dog be alone?
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Where will the dog be kept during the day?
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Where will the dog be kept when no one is home?
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Where will the dog stay during vacation and/or business trips?
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If your home has stairs, how many stairs, and explain
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Are you familiar with the necessary annual shots, as well as heartworm/flea medication?
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Yes
No
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)?
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Personal Reference
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Name, address, phone number, e-mail
Veterinarian reference (please call your vet and give permission to release information to us)
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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.
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Submit
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