Application for a Dachshund from Coast to Coast Dachshund Rescue

Application for a Dachshund
Coast to Coast Dachshund Rescue

www.c2cdr.org
It is important that you answers all of the questions. Some questions are mandatory. To leave blank answers may delay processing of the application. Thank you.
Date

MonthDayYearHourMinutesAM/PM Option
Your Name *

First NameLast Name
Name of dog you are interested in. Please enter the name and ID (Database ID) number of the dog you are interested in if you're interested in a specific dog. The ID number is on the biography of the dog at the top of the page with the rest of the information.
Your Email (REQUIRED)*
example@example.com
If you are currently working with a CCDR representative to help you find a dog, please provide their name and email address. If you are not working with a member, leave it blank.
What is the name of the representative that is listing this dog? This may be a different member than the member you are working with.
What is the email address of the member who has the dog?
Your Home Address (REQIRED, fill in all lines)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Best number to reach you at

CellHomeWorkAny number is fine
Cell Phone Number

Area CodePhone Number
Home Phone Number

Area CodePhone Number
Work Phone Number (List this if you are able to be contacted at work)

Area CodePhone Number
As the adopter, please tell us your age (REQUIRED)*
Please list everyone who lives in the home (you included) and put their age and their relationship to you
Is this application for a specific dog? Or do you wish to have an application on file so when the right dog comes along you can be considered?

Specific dog (You would have put the name of the dog at the top of the form if you are looking at a specific dog.)I don't see a specific dog yet so want to have an application on file
Do you often have other people visiting your home?

YesNoYes, but seldomOther
Do you have grandchildren or other children that visit? (This is asked because we'd want to make sure the dog you are interested is good with children or that you have a safety plan in place if your chosen dog isn't good with children.)

YesNoYes, but they don't visit oftenOther
If you don't have children, do other children, who are not related, visit your home?

YesNoVery seldom
Have you had a Dachshund before?

YesNoYes, but many years agoThis will be our first Dachshund
Is everyone in the residence and family agreeable to adopting a dachshund?

YesNo
Are you willing to teach all who live in your home or all who visit, the proper care and treatment of the dachshund?

YesNo
Children can be hard on a dachshund because they are a small breed. Are you willing to always monitor all children, especially young children, with the dachshund?

YesNo
If you are new to the dachshund breed or this will be your first dachshund, are you willing to learn all you can about the breed to learn they have special characteristics and can be prone to some physical issues (such as back issues, etc.?)

YesNoYes, but I have owned dachshunds so am very familiar with the breed
All of our fosters are fully vetted but once you take ownership, do you agree to take the dog to the veterinarian once a year for a wellness exam, shots when necessary, continue with any necessary medication, use flea and tick prevention if necessary, do a heartworm check and continue to practice good veterinary care for the dog?

YesNoPossiblyOther
Do you agree to take the dog to the vet if it becomes ill or shows signs of discomfort (back issues can cause them pain), injury or illness?

YesNoOther
Pets come with a financial obligation. Are you able to financially afford a dog, especially if it needs more than normal veterinary care? Dachshunds are prone to back issues which can be costly. We never expect issues, but they do happen and we appreciate honesty if you wouldn't be able to handle an expensive emergency.

Yes, I will do whatever it takesYes, but I may have difficulty if there is extreme veterinary costsI am on a fixed income so may have difficulty if it's an extreme costI may have trouble if it is extremely expensive, such as back surgery costs
Coast to Coast Dachshund Rescue requires a signature on the contract that states should you not be able to care for your Dachshund for any reason, whether financial or otherwise and must give up the dog, you will notify the person you adopted the dog from as well as us (info@c2cdr.org) first. You may not give your dog away, take it to a shelter or give it to another rescue, but, must return the dog to Coast to Coast Dachshund Rescue where we will be happy to help find it another home.

I will agree to thisI'm not prepared to agree to thisI won't agree to thisOther
Why do you want to adopt a rescue dachshund? We like to know our applicants understand the breed.
Who will care for the dachshund?
Where do you plan to keep your dachshund during the day?
Where will your dachshund sleep? The more detail you can give us the easier it is to know if our foster will be a good match.
Do you own other pets?*

YesNo
If you own other pets, what do you have?*

Another dog(s)Cat(s)Bird(s)Smaller pets, such as a rabbit, guinea pig or hamsterI have no other petsOther
How many dogs do you currently have and what breed? It is an important question to ask and it doesn't mean it impacts your ability to adopt.*
If you have a pet not listed above, please list it here. Some people have large animals such as horses, cows, goats, etc. List them here or enter "none."
If you own other pets, particularly small rodent type pets or birds, even cats, are you aware the dachshund has a prey drive and may become obsessed at trying to get to them where the small animal could be injured?

YesI didn't know thisI realize this but all cautions will be taken
If you have other dogs or cats, are they all altered?

YesNoNo, but I have a reason why they are not
If you do have an unaltered pet, please explain in detail why the pet has not been altered. It doesn't mean you'll be denied but we would need to know the reason you chose not to alter them. We realize some dogs have medical issues and your veterinarian advises not to.
Assuming you've had previous dogs, what happened to those no longer living with you. This is not to be intrusive but we appreciate knowing information about past pets.
Are you familiar with the unique personality of the dachshund

YesNot reallyThis is my first dachshund
Are you aware that dachshunds can have issues with their backs that will require possible surgery and can be very expensive? We ask this question because those who have never had a Dachshund are not aware how high the chances are that you may encounter back issues.

YesYes, but I am willing to handle this properly if it happensNo, I wasn't aware of them possibly having back issuesOther
Are you aware that the dachshund may not be the best breed for families with young children?

Yes, I realize thisYes, but I am very cautious and monitor my childrenNo, I wasn't aware there could be a problemThis isn't relevant in my situation
The dachshund breed can have issues with house training. Please be very honest in answering this question. Does the dachshund have to be fully house trained? We always tell our applicants that a dog is or isn't house trained while in foster care.

Yes, I only want a house trained dogI would prefer to have a house trained dog but realize I may have to do some refresher trainingNot being house trained is not a deal breaker and I will work with the dog regardless of its training
If needed, are you willing to house train your new dog? Often fosters need refreshing or new training. Are you willing to work with a dog that needs house training and what would your method be?
While we realize everyone would like to have the "perfect" dog, rescue gets in many types of dachshunds that need homes. Please check the boxes of dachshunds you would consider adopting.

I am willing to adopt an older dachshundI am willing to adopt a dog that was abusedI am willing to adopt a dog that needs ongoing medical careI am willing to adopt a bonded pairI am willing to adopt a dog that is physically handicappedI'd prefer to adopt a dachshund that didn't have many (or any major) issues and gets along with people and petsI am unable to adopt a dog that is not reliable with young childrenI prefer not to adopt an older dachshundI prefer not to adopt a dog that was abusedI prefer not to adopt a dog that needs ongoing medical careI prefer not to adopt a dog that is physically handicappedOther
Type of residence

HouseCondominiumApartmentOther
Type of residence

I own my homeI rent a homeI own a condominiumI rent a condominiumI rent an apartmentI live with family membersOther
If you rent, we have to contact your landlord to make sure you are able to have a dog or another dog if you already have one. Are you agreeable to this?

I understand this and am agreeableI prefer not to have my landlord contactedOther
If you rent and are agreeable to us contacting your landlord, please supply the name of the person to contact and their phone number.
Do you have a yard for the dog?

YesNo
If you have a yard, is it fenced?*

YesNoNo, but I have an invisible fenceI have a portion fenced for my dogI use an X-penOther
If your yard is not fenced, what is your exercise routine and how do you monitor your dog to relieve itself?
Do you have stairs in your home? (Dachshunds can have issues with stairs, especially if they have back issues. )

YesNoYes, but the dog won't be going up and down them.Other
Where will the dog be kept during the day if you work or are not home? You may explain your daily plan.
If you work, do you have an area for your dog to be or a plan for someone to let the dog out during the day? Please explain your daily plan.
Who will primarily take care of the dog?
How many hours a day will the dog be left alone?
Who will take care of the dog while you are at work (if applicable ie; no one, someone is home most of the time, dog walker, etc.)
Where will the dog sleep at night (crate, in bed with someone, anywhere they want?)
Would you be willing to take the dog to obedience training if needed? Sometimes fosters come in that have never had any type of training. Obedience training builds confidence and often times the dogs love it.

Yes, I'd be willing to do some training with my dogI am able to train my own dogProbably notOther
If you have a preference on age, size, color and coat type, please check all that apply. Keep in mind that rescue doesn't always have what a person is looking for so if you're willing to wait, the ideal dog may come into the system.
What age bracket are you looking for?

Puppy, under a year1 - 3 years3 - 6 years6 - 9 years9 years and olderAny ageOther
Size

Miniature (a true miniature size which is 11 lbs or under)"Tweenie" (an over-sized miniature that can go to 18lbs even to 25lbs)Standard (a true standard, (not a Tweenie) which can go up to 40 lbs.)I need to stay within a range I can easily pick up.No preference, just a great dog
Color

RedBlack and TanAny other colorNo preference, just a great dogOther
Coat type

SmoothLonghairedWirehairedNo preference, just a great dog
Please be very honest in answering this question. We only want to offer you dogs that meet your requirements where you will be very happy with your rescue dachshund. Please list the things that you wish out of a rescue and also please list anything you really cannot live with. If you cannot tolerate a dog that is not house trained, please list that. If you need a dog to get along with other dogs, cats, pets, we need to know that since not all dachshunds will. If you have children or grandchildren we need to know this so we can advise if a foster would be good with children. We do not want to show you dogs that won't work since that would be unfair to you and to the dog. Please be honest in your requirements. There is nothing wrong with being honest and it helps us tremendously since our goal is to help you find the right dog. We don't want you to be unhappy nor do we want our foster to not be loved because they have a trait you cannot tolerate. This is an important question.
Below is the area for references. Please fill out the information in full and make sure your references are aware we will be contacting them.
Veterinarian (REQUIRED - Name of vet, name of clinic, clinic address, phone number and email address if you know it. You will have to contact your vet to give them permission to answer a few questions from us*
Reference 1 (REQUIRED - Name, address, phone number, email, relationship to you)*
Reference 2 (REQUIRED -This person cannot be related to you, name, address, phone number, email) *
Reference 3 (REQUIRED -This person cannot be related to you, name, address, phone number, email)*
We do home visits. This is to meet you and your family, check to make sure the yard and home are safe and that everyone is on board for a new pet. The entire family should be available so we can meet them and also see how the dog you are interested in reacts to them. Are you agreeable?

YesNoI'd like to discuss this with you
If you have any comments or requests you'd like to make, please make them here so we can better understand what you're looking for.
Before you hit the submit button, please make sure you have filled out the fields asking for your name, your phone number, your veterinarian's information and the required references.

Good luck!
I am at least 21 years old and the information provided in this application (in its entirety) is true as of the date on this application and I understand my application can be denied if false information is given. By signing this I am stating I am financially able to care for a dog and can give veterinary care as needed. I also agree that should I not be able to care for my adopted dog I will contact the person I adopted it from (and CCDR - the contact info is on the website but you'd contact info@c2cdr.org) to let them know so CCDR can make arrangements to get the dog back at my expense. (Our contract states adopter returns the dog to us and if it was a long distance transport or out of state, the adopter is required to cover the cost of returning the dog to us.)

I give permission to have my references checked and agree that the information on this form is true and understand the conditions of a returned dog. Submission of this form will constitute a legal document once submitted.
Please type your name to acknowledge the above statement. This is equivalent to an electronic signature.
If you want to print your applicaiton, click the "Print Application" button before you click the submit button.
NOTICE: If you press the submit button but then get the "Undefined" message by the buttons, please scroll back up the form and look for the highlighted areas in red. Those are required fields that must be filled in to be able to submit the application.
Should be Empty: