ADOPTION APPLICATION

* = Required fields!  PLEASE NOTE: If I don't have a contact address or phone number I cannot reply to your submission!

Your Name(s):

Address: *

City: *

State: *

 

Home *

*

*

Email *(e.g. -johndoe@aol.com)::

Additional Email: *(e.g. -johndoe@aol.com):

Do you live in a:

If you rent, do you have your landlord's approval to own this dog?   Yes  No

Do you have a 6 foot fenced yard?  Yes  No

Type Of Fence:   (The more flexible you are the greater the chance of a perfect match.)

How old are you?

Do you have any children? 

Are you?

Do you have roommates?  Yes  No

Do you have other dogs/pets of any kind living with you?  Yes No

If so, what kind?

Have you ever been owned by this breed before? Yes  No

What traits are you looking for in a dog?


Why have you decided you would like this breed versus another breed?

Have you ever met a dog of this breed? Yes  No

Do you work  and if so, choose type of work?

Are you interested in a male or female?

Do you have a colour preference?

Can you also give me a second/ third colour preference?  

Do you have suggestions/ comments/ feedback, that may improve my website for other potential owners?

If so, please submit your comments/suggestions below:


Home   |   Candids   |   Links   |   Our Boys   |   Our Girls   |   Memories   |  Puppies   |   E-mail


 


Last Updated 02/20/2012.
Use of images, photos, graphics or text is  prohibited without written authorization 
from  EPRD Web Design,  Copyright Redmarsh Basenjis. All rights reserved.