This form in no way guarantees your place on a waiting list, or a puppy. It is simply designed to help me determine whether a basenji is right for your family, and what type of basenji puppy would fit best with your family.
INFORMATION ABOUT YOU
2. Your full name
3. Address (Street, City, State, Zip)
4. Phone
5. Best time to call
6: Email address
7. How often do you read your email?
INFORMATION ABOUT YOUR HOUSEHOLD
8. Number of adults in household
9. Number and age of any children in the household
10. Are you expecting a child or planning a family?
11. Do children regularly visit your home?
12. Do you own other dogs?
13. List all other dogs in the household. Include breed, age, sex and how long you've owned each one.
14. Do you own any cats?
15. List any details about cats
16. Do you own any other critters (small animals, birds, etc.)?
17. List details about the other critters
If you currently own other pets, we will contact your vet for a reference.
18. Veterinarian's name
19. Veterinarian's address (Street, City, State, Zip)
20. Veterinarian's phone or email
21. Do you live in a house, apartment, condo or farm?
22. Do you own or rent your home?
23. Is your neighborhood urban, suburban, rural or remote?
24. Do you have a secure yard?
25. Please describe your yard and fence (height, type, etc.)
26. Anything else about your family you'd like me to know?
INFORMATION ABOUT YOUR GENERAL BASENJI EXPERIENCE
27. Have you ever owned a basenji before?
28. What do you know about basenjis?
29. Have you met a basenji before?
30. Have you spoken with a basenji owner?
31. What qualities appeal to you about a basenji?
32. Why do you want a basenji?
33. Are you currently a member of the BCOA, or any AKC affliated all-breed, breed or performance club? Please list.
34. Where will the basenji stay when it's alone?
35. Where will the basenji sleep?
INFORMATION ABOUT THE DOG YOU WANT
36. Do you want: male, female, no preference.
37. Color: red/white, black/white, tricolor, brindle/white, no preference
38. Generally speaking, what kind of temperament are you looking for in a dog?
39. Which of the following do you plan on doing with your basenji:
showing in conformation
obedience
lure coursing
agility
therapy work
family pet
other (please explain)
40. If you are wanting a show dog (conformation), have you ever shown in the AKC before?
41. Any other questions or comments?
HOME / FAQS / BOYS / GIRLS / AVAILABLE / LITTERS / LINKS