Atticus Buddy Gracie Sammie Rosebud Alani Sugar Magnolia Tripod Jack, Sugar Magnolia, and Henry
Colorado Basenji Rescue ...providing rescue, foster-care & placement of Basenji, and Basenji-mix dogs.
TABLE OF CONTENTS
APPLICATIONS
CONTINUING STORIES:
THIS WEBSITE WAS LAST UPDATED: 07/17/2017

PRE-ADOPTION QUESTIONNAIRE

Please fill out questionnaire completely to be considered.
 

* REQUIRED

I. Personal Information:

* Your name:
* Street Address:
* City:
* State:
* Zip:
Country:
* Home Phone:
* Work Phone:
Cell Phone:
* E-Mail:
* Age:
* Place of Employment:

 

II. To help us make an appropriate "match" between you and a deserving Basenji, please give thoughtful attention to answering the following questions:

1. What draws you to the Basenji breed?

 

2. What experience/knowledge do you have regarding Basenjis?

 

3. Do you own your home? (If renting, please include your landlord's name and phone number):

 

4. List all other members of your household, their ages, and relationship to you:

 

5. List the animals living in your household:

 

6. Do you have a securely fenced yard? What type of fence? What is the height of the fence? How will you exercise your Basenji?

 

7. List the animals you have had in the past and what became of them:

 

8. Give a "day in the life" description of what it will be like for a Basenji living with you; where will s/he sleep? where will s/he be while you are away from the house, etc.:

 

9. Describe the personality traits of your "ideal" Basenji:"

 

10. Describe Basenji personality traits you do not desire:

 

11. Do you have preference for male or female? Why? What age range would you prefer? Are you flexible?

 

12. Please check the areas you are willing to work with:

Socialization Separation Anxiety
Basic Obedience Destructive Chewing
Leash Pulling Fears/Phobias
Housetraining High Energy
Puppy Training Crate Training
Geriatric Concerns  

 

13. Please check the areas you already have experience or expertise in:

Socialization Separation Anxiety
Basic Obedience Destructive Chewing
Leash Pulling Fears/Phobias
Housetraining High Energy
Puppy Training Crate Training
Geriatric Concerns  

 

III. Veterinarian:

If you do not currently have a veterinarian, please list your most recent veterinarian and their contact information.
 

Name:
Address:
Phone:

 

IV. Personal References:

Please list three personal references, two being non-family members:
 

Name #1:
Full Mailing Address:
Phone Number:
Relationship:

 

Name #2:

 

Full Mailing Address:
Phone Number:
Relationship:

 

Name #3:

 

Full Mailing Address:
Phone Number:
Relationship:

 

 

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FEATURED BASENJI!
Jaco and Juniper
Learn about Jaco & Juniper!
 
HOW TO ADOPT
Please complete our
Pre-Adoption Application even if our current Basenjis do not match your needs. We may have dogs available soon that are now in the intake process (Basenjis are listed after they are thoroughly evaluated & deemed healthy). When a dog needs emergency placement, we check our database for pre-approved applicants to foster or adopt.
 
LOST ID TAG?
Please contact CBR for a free replacement!
 
MOVING?
Please contact CBR to update your address & phone number!
 

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