Online Application

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Date

What draw you to the breed?

Please provide the following contact information:

Name
Address
City
State
Zip Code
Day Phone
Evening Phone
E-mail

Number of Adults in household.

Number of children in household.

Ages of children in household.

What do you do for a living?
Let us know what your work schedules are like.
How many hours a day are you away from home for work/school etc?
Is your job flexible enough to allow you to come home at lunch time
for the first few months to let a puppy go potty?

Type of dwelling.

house condo/townhouse apartment other

Do you Own or Rent?

own rent

If renting: Do you have landlord approval to have a pet?

yes no

If renting: Name and phone number of landlord/rental agency.

Do you have a fenced yard?

yes no

If not, what will an average day of exercise be like for you and your Basenji?

What kind of fencing do you have?

chain link privacy fence N/A

How tall is your fencing?

4 foot 5 foot 6 foot N/A

Basenjis are sighthounds (they hunt by sight and chase anything
that moves-squirrels, rabbits, birds, and sometimes cats).
This means that Basenjis can never be let off leash except in a securely fenced area.
The number one leading cause of death in Basenjis is by being hit by a car.
If you have children, or other members of your household, can you set up your
home in some manner so that your dog does not get out of the house
while people are going in and out? We suggest a scat mat by the door.
It works great in your house, our dogs learn to stay back behind the scat mat
when people are going in and out of the door.

Do you have a doggie door?

yes no

Number of dogs in household

0 1 2 3 4+

Number of cats in household.

0 1 2 3 4+

How would you classify your home?

calm, fairly quiet
moderately active
very active and/or frequent visitors

Does anyone in the family have pet-related allergies? If so, how will they adjust to living with a dog?

List ages and breeds of pets in household. Please tell us a bit about their personalities.
This will help us make a match when considering your application.

Are all of your pets spayed or neutered?

yes no N/A

Where do your dogs stay while you are away from home?

In the yard
In a crate
In the garage
In the house confined to an area
In an outdoor run/pen
In the house not confined to an area

Where will the dog sleep?

Name and Phone number of Vet. Please include last name on your account at the Vet clinic.
We will check with your Vet for Veterinary history. If you are new to the area, and do not
have a Vet in Colorado, please include a Vet reference from your former city.

List any pets you have previously owned: (If deceased, cause of death)

Do you have a Basenji age preference? Please note: We sometimes have retired champions who would like to have a family of their own.

puppy to 24 months
2 - 6 years
7 years to Senior
age does not matter

Do you have a Basenji gender preference?

male
female
No preference

Do you have a Basenji color preference?

Red & White
Brindle & White
Tri-Color
Black & White
Color does not matter

Any particular reason for your choice of color?

What type of Basenji Personality would best fit your household?

playful, outgoing
quiet
active
calm
intense
mellow
obedient
goofy and silly

Have you ever had a Basenji?

Yes, I have a Basenji now
Yes, in the past
No

What experience/knowledge do you have of Basenjis?

Have you researched the breed?

yes no

What kind of research have you done?

Have you ever had to give a dog up? If yes, please explain the circumstances.

You must not sell or give away this Basenji under any circumstances.
If you find it necessary to part with this dog for any reason
during its entire lifetime (and things do come up that are unforeseen),
you must contact me and I will happily take possession of the dog.
We are responsible for the health and happiness of every one of the dogs we breed,
and we want to make sure each finds the home they deserve.

Are you interested in showing your Basenji? Obedience training?
Lure coursing? Having a litter of puppies some day? Or simply want a pet?

Please provide any additional information that would be helpful
in considering your application for buying a puppy from us.

All our pet puppies are sold on a spay/neuter contract.
The AKC registration papers are not given until proof of the spay/neuter is provided.
You will be given a bill of sale and a signed contract at the time the puppy is picked up.

We do not let the puppies leave here until they are at least 9 weeks old.
It may be longer depending on the individual puppy and home.