Connecticut Dachshund Rescue and Pet Services Application

Dachshund Rescue and Pet Services PO Box 784 Killingworth, CT 06419 (860) 395-8929 eliot@ctdoxierescue.com
Potential Adopter’s Information Please fill out the entire form below and click the "Send" button when finished.
Name:	Phone:
Email:
Address:
Family Members and Ages:
Do you or anyone in your family smoke? Yes/No	Do you smoke in the house? Yes/No
Do you have a fully fenced in yard? Yes/No

Work Schedule:
Name, Address & Ph# of your Vet. Please give your vet permission to speak to us.
Please tell us about any previous experience with a Dachshund.
What specific dog(s) are you interested in?
What are you looking for in your adopted dog?
Please list any other animals you have living at home:
What brand of food do you feed your dog?

	Dachshund Rescue and Pet Services PO Box 784 Killingworth, CT 06419 eliot@ctdoxierescue.com

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