Adoption Application (Test Page)

Applications can be submitted at any time. They are not pre-approved and will be kept on file for one year.
If you have an application on file and a dog you are interested in becomes available, please contact ACDR requesting to be considered.
Adoption fees for one dog range from $200 to $500, depending on the age of the dog.
All fields are mandatory. If a question does not apply, please enter ‘N/A’ in order to proceed to the next page. Incomplete applications cannot be submitted.

1Contact Information

2Verification

3Environment and Preferences

4Signature

Applications can be submitted at any time. They are not pre-approved and will be kept on file for one year. If you have an application on file and a dog you are interested in becomes available, please contact ACDR requesting to be considered. Adoption fees for one dog range from $300 to $600, depending on the age of the dog. All fields are mandatory. If a question does not apply, please enter ‘N/A’ in order to proceed to the next page. Incomplete applications cannot be submitted.

Name:(Required)

First Last

Address:(Required)

Street Address Address Line 2 City Province Postal Code

Cell Phone:(Required)

Home Phone:(Required)

Email:(Required)

Date of Birth:(Required)

Month

Day

Year

Family Unit - List all names, ages, and relationships to the applicant:(Required)

Employment - List occupation, workplace, and hours worked for each adult:(Required)

Family Activity Level:(Required)

Who will be the primary caregiver for this dog? Who will care for the dog when the primary caregiver is away? (either at work, on vacation, or for an unexpected period away)(Required)

How many hours will the dog be left home alone? Where will the dog be kept during these hours?(Required)

How often, on average, do people visit your home?(Required)

Explain briefly how you will introduce visitors to your dog(Required)

Have you taught your children (or how would you teach visiting children) to interact with your dog?(Required)

What type of home do you live in?(Required)

Do you own or rent your home?(Required)

Own

Rent

If renting, are pets allowed?(Required)

If renting, provide the name of your landlord and phone number:(Required)

Do you have a fenced yard?(Required)

Are you planning on any of the following in the next 3 to 6 months....moving, vacation, change in schedule (work or recreation)?(Required)

Are you a first-time dog owner?(Required)

Do you own any pets currently? (list each pet by name, breed and age)(Required)

Have all the animals listed above been spayed/neutered? If not, what are the circumstances?(Required)

If you currently have a dog(s) in your home, have they ever shown any aggression or reactivity towards another dog?(Required)

If you currently have a dog(s), how often do you socialize them with other dogs?(Required)

If you had a pet in the last five years that is no longer with you, explain why they were sold, surrendered or given away. If the pet died, what was the cause of death and the age of the pet?(Required)

Have you ever adopted from another rescue or shelter? If yes, provide details.

Approximately how much do you think your dog will cost per year including medical, food, grooming, training, boarding, etc?(Required)

What is your opinion of obedience training? Do you have any experience with training a previous pet?(Required)

Are you interested in a specific dachshund available through ACDR? If yes, provide name.(Required)

Do you have preference for a certain type of dachshund? If so, specify (ie. sex, size, coat, puppy/adult/senior, etc)(Required)

If you have indicated preferences, explain them (why you prefer male vs female, short vs long coat, etc)(Required)

If you have indicated preferences, are you flexible? Do you have a second choice?(Required)

What issues are you willing to work with?(Required)

House training

Medical issues / on medication

Shy or fearful

Known not to be good with children

Separation anxiety

Mild aggression

Obedience

Reactive to other dogs

Barking

I am not willing to work with any issues

I need more information to decide

Under what circumstances would you return your dog?(Required)

Moving

Cost

New baby

Aggression

Medical reasons

Not enough time

Behavioural issues

Never - I am adopting fully aware rescue dogs often come with issues

Other

What do you think is the most important responsibility of owning a dachshund?(Required)

Vet Reference - Provide clinic name, phone number, and address of your vet. Required for all applicants who own or have owned a companion pet. If the account is not under your last name, provide the name it is under. Notify your vet to give them permission to speak with ACDR about your pet).(Required)

If you do not have a vet, do you know of one in your area accepting new patients?(Required)

Personal Reference #1 - Provide name, telephone number, relationship to applicant, and length of time known (not family):(Required)

Personal Reference #2 - Provide name, telephone number, relationship to applicant, and length of time known (not family):(Required)

Is there any further information you would like to include?(Required)

Date(Required)

Month

Day

Year

Signature(Required)

You can use your mouse or if you're on a phone or tablet, you can use the touch screen to sign your name here.

This field is for validation purposes and should be left unchanged.

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Adoption Application (Test Page)

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