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Adoption Application
Name
Email Address
Home Number
Cell Number
The best number to reach me at is:
Home
Cell
The best time to call is:
Home Address
I live in a:
House
Condo/Townhouse
Apartment
Trailer
If you have a landlord, are you allowed pets ?
I do not have a landlord
Yes, my landlord allows pets
I am not sure if my landlord allows pets
No, my landord does not allow pets
Is there a Yard?
Yes, I have a yard
No, I do not have a yard
If there is a yard, is it fully fenced (no holes) ?
N/A
Yes - I do have a yard and it is fully fenced with no holes
No - I do have a yard but it is not fully fenced
Does your home have stairs ?
Yes, I do have stairs
No, I do not have stairs
If yes, how many ?
N/A
1 to 3
4 to 7
8 or More
Are you planning to move ?
I am not sure at this time
Yes, I am planning to move soon
No, I am not planning to move
If yes, how soon ?
I am not planning to move
1 to 2 Months
3 to 4 Months
5 to 6 Months
6 Months or More
I don't know
Name and Ages of everyone in the home
Is everyone in the home agreeable to adopting a dachshund?
Yes, Everyone is agreeable to adopting a dachshund
No, there is someone that does not agree
I am unsure of everyone's feelings at this time
If No, who and why ?
Have you owned a dachshund before?
Yes, I have owned a dachshund before
No, I have never owned a dachshund before
If Yes, What happened to the dachshund ?
Do you have any other pets in the home?
No, there are no other pets in the home
Yes, there are other pets in the home
If yes, What kind ? How many ? Please Describe thier temperament
Do you have small children live in the home or visit ?
Yes, there are small children in my home
Yes, there are small children who visit my home
No, there are no small children in my home OR visit
If Yes, Are you willing to teach them proper behavior with the dachshund
Yes, I am willing to teach proper behavior
No, I am not willing to teach them proper behavior
N/A
How long will the dachshund be alone during the day ?
1 to 2 hours
3 to 4 hours
5 to 6 hours
6 hours or more
I work from home
I am home a majority of the time
How long will the dachshund be alone during the night ?
1 to 2 hours
3 to 4 hours
5 to 6 hours
6 or more hours
I am always home at night
I am home the majority of the time at night
Where will the dachshund be kept while no one is at home ?
Where would the dachshund sleep ?
Are you willing to take on financial responsibility of the dachshund ?
Yes, I am willing to take on complete financial responsibility
Yes, but for food only
No, I am not willing to take on financial responsibility
No, I am unable to take on financial responsibility
Are you willing to take the dachshund to the vet for yearly check - ups and emergencies ?
Yes, I am willing to take the dachshund to the vet for yearly check - ups and emergencies
Yes, but only in emergencies
Yes, but for vaccinations only
No, I am not willing to take the dachshund to the vet
Name, Current Address and Phone Number of your Vet
Are you willing to train the dachshund ?
Yes, I am willing to train the dachshund daily
Yes, I am willing to train the dachshund weekly
Yes, I am willing to train the dachshund monthly
No, I am unable to train the dachshund
Are you willing to groom the dachshund ?
Yes, I am willing to groom the dachshund twice a week
Yes, I am willing to groom the dachshund once a week
Yes, I am willing to groom the dachshund once a month
No, thats why I want a Smooth Dachshund
Preferred Age (Press ctrl for more than 1):
Puppy Under 6 Months
Puppy Over 6 Months
Adult - 1 to 2 Years Old
Adult - 2 to 5 Years Old
Adult - 5 to 7 Years Old
Senior - 8 or More Years
I have no preference
Preferred Size (Press ctrl for more than 1):
Mini (under 11 lbs)
Tweenie (12 to 15 lbs)
Standard (over 16 lbs)
I have no preference
Preferred Coat (Press ctrl for more than 1):
Smooth
Long
Wire
I have no preference
Preferred Color (Press ctrl for more than 1):
Red
Black/Tan
Black/Cream
Chocolate/Tan
Chocolate/Cream
Blue/Tan
Blue/Cream
Isabella/Tan
Isabella/Cream
I have no preference
Preferred Pattern (Press ctrl for more than 1):
Dapple
Double Dapple
Brindle
Brapple (Dappled Brindle)
Piebald
I have no preference
Hypothetically, What would you do if the dachshund became Special Needs (daily medication, broken back, special diet etc)
Are you over 21 Years old?
Yes, I am over 21
No, I am under 21
Are you willing to have a home inspection ?
Yes, I am willing to have a home inspection
Yes, but I am not in Alaska
No, It is not necessary
Are you willing to return the dachshund if you can no longer care for him/her ?
Yes, I am willing to bring back the dachshund
No, I will rehome the dachshund myself
No, I will take the dachshund to a rescue/shelter
Do you have any questions, comments or concerns ?
How did you hear about us (Press ctrl for more than 1)?
Search Engine
A Forum
A Friend
A Puppy Adopter
An Ad
Personal Meeting with Angela or Sherry
Call Us....
Angela: (907) 775 - 1128
Sherry: (907) 232 - 2061
Email Us....
info@alaskanlowriders.com
Fill out a Form....
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