Remove This Dog

Use this form to notify the BRAT Administrators that a dog has been adopted.
( * ) Indicates a required field.

Dog Name *
Dog is Basenji or mix?	Basenji Mix
Dog's State
Is the dog listed on BRAT's Web site?	Yes No
If so, in which state?
Coordinator Name *
Coordinator E-mail *
Adoptee Name *
Adoptee Address *
Adoptee City, State and Zip *	,
Adoptee Phone Number (incl. area code) *
Adoptee E-mail *
Adoption Date
Adoption Fee
Comments
Leave Applicant on the BRAT-RESCUE list?	Yes No