Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender Preference *

Male

Female

No Preference

Colour Preference (1st) *

Chocolate & Tan

Black & Tan

Red

Cream

No Preference

Colour Preference (2nd)

Chocolate & Tan

Black & Tan

Red

Cream

Colour Preference (3rd)

Chocolate & Tan

Black & Tan

Red

Cream

Pattern Preference *

No Pattern (solid colour)

Dappled

Piebald

No Preference

Do you own, or have you owned a Miniture Dachshund? *

Yes

No

Are you aware of the possible health issues of this breed? *

Yes

No

Do you have a fenced yard? *

Yes

No

Do you have any other animals? *

Yes

No

Do you have small children? *

Yes

No

Is your partner/family/housemate onboard with getting a puppy? *

Yes

No

Do you have approval from your landlord to have a puppy? *

Yes

No

Not Applicable

On average, how many hours will you be leaving the dog at home alone per day? *

0-2 hours

3-5 hours

6-9 hours

10+ hours

Do you require transport to get the puppy? *

Yes

No

Are you willing to stay in contact with us? *

Yes

No