Application to adopt or foster a Rescued Dachshund

Benny Archuleta offers for adoption unwanted, neglected, abused and abandoned dogs for a fee. The adoption fee is based strictly on the age (or estimated age, as determined by a veterinarian) of the animal placed and rarely covers the full amount of the medical expenses associated with saving these dogs. All rescue dachshunds are spayed or neutered before placement, vaccinated, heartworm tested and fecal tested. Any internal parasites will be eradicated and the animals will be as healthy as we can possibly make them. The adoptive home will be advised of any issues which will require ongoing care prior to being asked to accept the animal into their home.

To help ensure the best possible placement of our rescued dogs and in order to determine that the proposed adoption is in the best interest of both the Dachshund and the adopting family, please complete each of the following questions honestly and thoroughly.

This form is set for delivery to Benny Archuleta, at benny.archuleta@dachshund-rescue.org. You will receive an automated acknowledgement when it has actually been opened. Regrettably, it is no longer possible to consider "out of area" adoptions. It is hoped that this change to policy will only be temporary. For the purposes of this policy, "out of area" is considered to be anything outside of a three hour driving radius of Jacksonville, Florida. Applications from "out of area" must be discarded without consideration.

Incomplete or inaccurate applications will not be considered. You will not be advised if your application is disqualified for this reason.
The information you provide WILL be checked.

Mailing Address
City State Zip Code County

Physical Address
City State Zip Code County

E-mail Address
Home Phone

Your Occupation:
Your Work Phone:
Name of Employer:
How long there?
Spouse or co-applicants Occupation:
Spouse or co-applicants Work Phone:

Name, address and telephone number of Veterinarian:

Note: Applications which do not include a veterinarians phone number will not be considered.

Please provide name, address and telephone numbers for three individuals not related to you who can serve as references:

1.
2.
3.

Do you own or rent your home?
Own Rent

If renting, is landlord agreeable to you having a rescued dachshund?
Yes No Not applicable

If requested, can you provide us with such permission in writing?
Yes No
How long have you lived at your current address?

Are you interested in adoption?
Yes No
Are you interested in providing foster care?
Yes No

May we visit your home and check your references to verify the information you have provided?
Yes No

Do you currently own any other pets?
Yes No

if yes, please list name, age, species and breed of each:

1.Spayed or neutered? Yes No

2.Spayed or neutered? Yes No

3.Spayed or neutered? Yes No

4.Spayed or neutered? Yes No

(If any animal above is not spayed or neutered, please be prepared to provide copies of your A.K.C. membership papers, breed club membership papers and breeder credentials, as well as a 5 generation pedigree for each unaltered animal listed above.)

Why do you want a Dachshund?

Is everyone in the residence and family agreeable to adopting a dachshund?
Yes No

Is anyone in your household allergic to dogs?
Yes No

Have you ever owned a Dachshund before?
Yes No

How have you educated yourself about Dachshunds?

Describe the grooming care you would provide for your Dachshund:

What do you anticipate the cost will be to provide basic care for your Dachshund (grooming supplies, vet care, dental cleanings, food, license, toys, bed)?

What do you plan to feed your Dachshund? Be specific please (what brand).

Please list your preference regarding:

Preferred Color:

Red
Black and Tan
Other
No Preference

Preferred Coat:

Smooth
Long
Wire
No Preference

Preferred Size:

Standard (18 lbs and over at 12 months of age)
Miniature (11 lbs and under at 12 months of age)
"Tweenie" (that unrecognized size between 11 and 18 lbs)
No Preference

Preferred Gender:
Neutered Male
Spayed Female
Either is fine

Preferred age range of Dachshund:
Over 10 years
7 to 10 years
5 to 7 years
Under 5 years

Will you consider a "special-needs" Dachshund?
Yes No

Will you consider something other than your stated preference?
Yes No

Would you consider adopting a pair of dachshunds in the case of dogs that should not be separated and need to be placed together?
Yes No

Where will you keep the Dachshund (please be specific):
during the day?
during the night?
during vacations or while you are away for overnight?

Where will the Dachshund sleep at night? in a crate  in a pet bed  in your bed
other: (describe)

Do you have a safe and securely fenced yard (well maintained: no loose boards, no gaps, holes or protruding nails)?

Yes No

How large is the area that is fenced?
What type of fencing do you have and how high is it?
Do you have a doggy door to the yard?
Yes No
If you do not have a fenced yard, how do you plan to exercise the Dachshund, confine the Dachshund and provide for his need to eliminate?

Are you committed to walking your Dachshund, weather permitting?
Yes No
How often and for how long will you walk your Dachshund?

Dachshunds need regular potty breaks in order to be successfully housetrained. For your own benefit as well as the benefit of any Dachshund we might place with you please consider the following questions:

If you are gone from the home on a daily basis, give a breakdown of your daily routine:

1. Bedtime until morning:
2. Morning before work or school:
3. Hours away from home at work/school/errands:
4. Back home in evening:
5. Hours gone during evening:

What category best describes your household's schedule:

1. Stay at home/few outside activities
2. Work from home
3. Work outside home but have staggered/flexible schedules
4. Retired, mostly home
5. Work a fixed schedule

Realistically, how many hours a day will you spend with your Dachshund (excluding sleep)?
Are you able to come home in the middle of the day to walk the Dachshund and give it a potty break?
Yes No
What is the maximum number of hours your Dachshund will be left alone during a 24 hour period?
How many of these hours will the Dachshund be confined without a potty break?
Where will the Dachshund spend this time (please be specific)?
When you are away from home will your rescue Dachshund have companionship?
Yes No
What kind of companionship will he have (another canine, cat, human)?
If you don't already have a Dachshund, would you consider adopting two dachshunds to keep each other company?
Yes No

Do you object to the discriminate use of a crate?
Yes No
Do you have a crate?
Yes No
What size is it?
Would you get one?
Yes No

What will you do if your Dachshund is destructive when left alone?

Are you willing to attend obedience classes with your Dachshund?
Yes No

Have you ever trained a Dachshund before?
Yes No

Have you ever surrendered a pet of yours to an animal shelter?
Yes No

If yes, why?

Have you ever sold or given away a pet?
Yes No

To whom?

Why?

Keeping a Dachshund requires a financial commitment. Some of the costs involved include food, veterinary and dental care, fencing, crate, leash, collar, ID tags, bedding, nail clippers and grooming supplies. In addition to the initial cost of the crate etc., can you afford to spend at least $800 a year for food and routine medical care for your pet (this does not anticipate emergency care or grooming)?
Yes No

What are the requirements for animal ownership in your community?

How many animals may you legally keep at your residence?

Are animals required to be licensed?
Yes No

Are animals required to be vaccinated against rabies?
Yes No

Is there a barking ordinance?
Yes No

Are you required to pick up after your pet both in your own yard as well as on walks?
Yes No

Is there a leash law?
Yes No

What circumstances, in your mind, justify giving up/relinquishing a Dachshund?

What circumstances, in your mind, justify euthanizing a Dachshund?

What plans have you made for your Dachshund should anything happen to you?

Have you provided for your pet's care in a will?
Yes No

Does your family know of your wishes?
Yes No

Who will take in and care for your pet if you cannot?:

If you are inquiring about a specific animal, please enter that animals name here:

Thank you for taking your time to complete this application. By "signing" below you attest to the truthfulness of your answers. Falsification of any of the above information will be grounds to disallow your adoption of a rescued Dachshund. Failure to provide an answer to each and every question will disqualify your application, without explanation. Please verify that you have provided an answer to EVERY question before pressing the button to submit this form for processing.

   
(enter your name here to "sign")              (enter your name here to "sign")

(If there are two responsible adults in household, each must "sign" as an applicant.)
WARNING! - This online adoption application has no optional fields. Before pressing the submission button below, please take a few moments to ensure that you have answered every question. Otherwise, the script will generate an error page and when you click your back button, all your previous answers will have been deleted.

BENNY ARCHULETA RESERVES THE RIGHT TO REFUSE ANY ADOPTION FOR ANY REASON.