Neither Basenji Rescue & Transport, Inc. ("BRAT"), nor its volunteers, coordinators, representatives, Internet Service Provider and its officers, employees, contractors and representatives; and any other person, firm or corporation involved with the efforts or business of this corporation, shall be held liable or responsible for any claims or causes of action incurred as a result of the provision or restriction of information, services, contacts, adoptions, fostering, veterinary care or by the actions of any and all dogs transferred or referenced herein.

Moreover, there is absolutely no guarantee made or implied that any person requesting to adopt a dog being fostered through BRAT, or posted on BRAT's website, will be allowed to adopt a BRAT dog. Rather, all adoption applications are subject to acceptance based on a review process that may require collecting information from references and visiting the applicant's home. All decisions on placing dogs in adoptive and foster homes are based solely on the judgment of the volunteers and coordinators of BRAT and adoption applications submitted through this form are often denied for various reasons. BRAT reserves the right to make all decisions regarding placement or final disposition of any rescued dog in its care whether in, or being placed in, a foster or adoptive home or other facility. In addition, many of the dogs posted on BRAT's website are under the control of other shelters or rescue groups, and BRAT has no control over how these dogs are placed.

By clicking the "Send Information" button on the next page, you attest that you have read the above disclaimer and agree to the terms therein. In addition, pursuant to the requirements of various state statutes, you are also certifying that you have never been convicted of animal cruelty, neglect, or abandonment. If you do not agree to the disclaimer or cannot make the required certification, please return to our home page to quit this process.

Answer the form as completely as you can and remember that your name and email address are required. Your responses will only be used in rescue-related activities but may be posted to a private website and may be read by a network of BRAT volunteers and coordinators. Your information may also be transmitted via email to the same. Please note that adoption applications will only be accepted from persons 18 years old or older.

Click Verify Entries at the bottom of the form to view and check your information. (*) Indicates a required field.

Your Contact Information

* First name:
* Last name:
* Address:
* City:
* State / Zip / Country:
Work phone:
Best time to call:
Non-work phone:
Best time to call:
* Email address:
How often do you read your email?
Every hourOnce a dayTwice a week
Once a weekOnce a month

About You, Your Family and Household

Your age:
Your occupation:
Are there other adults in household?
How many minor children living in home?
Are you expecting a child or planning a family?
Do children under 8 years old regularly visit your home?
Please tell us about your family.
Include first and last names of other adults in your household.
Who will be the primary care giver for your dog?
Is there someone home during the day?
Do you travel for your work?
Would you say you have an active lifestyle?
(about 20 lines max) 
Your home is a:
HouseApartmentMobile HomeCondo
Do you own or rent your home?
If renting, does your landlord allow dogs?
YesNoNot sure
Your neighborhood is:
Do you have a secure yard?
Do you have or plan to use invisible or electronic fencing?
Describe your yard and fence (height and material):
If you have or plan to install electronic fencing,
please describe, and also read the BRAT FAQ on the
use of electronic fencing.
(about 10 lines max) 
Do you own other dogs?
List all other dogs in the household.
Include names, age, sex, breed, and how long you've owned:
(about 10 lines max) 
Do you own cats?
List details about the cats:
Include names, age, sex, breed, and how long you've owned:
(about 5 lines max) 
Do you have other animals or critters?
Please list details about the other animals or critters:
(about 5 lines max) 
If you own dogs or cats now, are they spayed or neutered?

If your dogs or cats are not spayed or neutered, why not?
(about 5 lines max) 
Do you support crating?

About Your Veterinarian

Please provide contact information for your primary veterinarian. If you use more than one vet, please use the last comment box to provide contact information for them.
Name of veterinary practice or hospital:
City / State / Zip:

Your Basenji Knowledge

Have you owned a Basenji?
Have you read any books about Basenjis? What do you know about them?
(about 20 lines max) 
Have you met a Basenji?
Have you spoken to a Basenji owner?
Would you like to visit a Basenji or have one visit you?

Would you like more information about Basenjis?
How did you learn about BRAT?

About The Dog You Want

RedBlackTriBrindleAny color
Puppy1 to 4 yrs5 to 8 yrs
Older than 8Any age
Would you consider adopting more than one Basenji?
Generally speaking, what kind of temperament are you looking for in a dog?
(about 20 lines max) 
What qualities appeal to you about the Basenji?
(about 10 lines max) 
In a typical day, how much time will the dog be alone, and when alone, where will it stay?
(about 10 lines max) 
Where will the dog sleep?
(about 10 lines max) 

Anything Else

Please use this space to add any other comments, expectations or concerns you have:
(about 20 lines max)