of SAN DIEGO

Waiting List Information Sheet

All information MUST be entered. Incomplete submissions will NOT be considered!

Information about you: (Required)

First Name:

Middle Initial:

Last Name:

Street Address:	Apt/Space #:
City:
State:
Zip:
Home Phone:
Work Phone:	Ext:
Fax:
E-mail address:

Have you ever owned a dog before?	Yes No
If yes, what happened to it?
Have you ever owned a dachshund before?	Yes No
Are you familiar with dachshund traits?	Yes No
Would you consider two dachshunds if they were a bonded pair?	Yes No

Information about the dog you want:

Preferred sex of dog:	Male Female Either
Desired coat:	Smooth Long Wire Any
Desired size:	Mini Tweenie Standard Any

Note: Mini — up to 11 pounds at one year;
Tweenie — 12 to 17 pounds;
Standard — 18 or more pounds.

Desired maximum age:
Desired maximum weight:
Desired coat color:

Information about your home:

I live in a House Condo Apartment Mobile Home
Are there stairs? Yes No

Yard?	Yes No	Fenced?	Yes No	Is fenced area secure without holes?	Yes No
Pool?	Yes No	Fenced?	Yes No	Is fenced area secure without holes?	Yes No

Will dog be indoors outdoors both. Comments:
Type of outdoor shelter:
Will there be a doggie door? Yes No
Where will the dog sleep?
How many hours a day will the dog be left alone?
Do all family members agree to get a dachshund? Yes No
Are there children in the household? Yes No If yes, how many? Sex/Age:
Do children visit? Yes No If yes, Sex/Age:
Is anyone in the household allergic to pets? Yes No

Are there other pets in the household?
Dogs? Yes No
    If yes, Sex/Age: Neutered/Spayed?Yes No
Cats? Yes No
    If yes, Sex/Age: Neutered/Spayed?Yes No
Birds? Yes No
Other pets? Yes No
    If yes, Neutered/Spayed?Yes No

Additional Comments: