Name of Applicant *

First Name

Last Name

Name of Significant Other

First Name

Last Name

Physical Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Postal Address, if different from above

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do You Live In *

House

Apartment/Unit

Townhouse

Villa

Acreage

Retirement Living

Do You *

Own

Rent

Live With Parents

Landlord's Name

First Name

Last Name

Do You Have a Dog-Proof Fence *

Yes

No

Are The Gate(s) Typically Locked?

Yes

No

Do You Have a Pool? *

Yes

No

Do You Have a Doggy Door? *

Yes

No

Have you owned a dog before? *

Yes

No

Currently

Have you owned a dachshund before? *

Yes

No

Currently

Is this your first time raising a puppy? *

Yes

No

Do you already have a veterinarian? *

Yes

No

Why Do You Want A Puppy? *

House Pet

Companion for Children

Companion for Family

Companion for Other Pet

Guard Dog

Breeding

As A Gift

Do you prefer *

Female

Male

No Preference

Do you prefer

Long Hair

Short Hair

No Preference

Pattern Preference

Solid

Piebald

No Preference

First Colour Preference

Cream

Black & Cream

Red

Black & Tan

Blue & Tan

Chocolate & Tan

Isabella & Tan

Second Colour Preference

Cream

Black & Cream

Red

Black & Tan

Blue & Tan

Chocolate & Tan

Isabella & Tan