Thank you for your interest in and consideration of Taji Basenjis. Please take the time to answer these questions completely so that our time together going forward will address your needs and my concerns efficiently.

First Things First:

  How did you come to find Taji Basenjis?

  Would the Basenji that you are looking to acquire live with you? NoYes

Tell me about yourself:

  Name:    Your age: 

  Email Address: 

  Street Address: 

  City:    My State:    Zip/Postal Code: 

  Daytime Area Code:    Daytime Telephone number: 

  Evening Area Code:    Evening Telephone number:   Fax: 

  Type of work: 


Tell me about your household:

  Do you have a domestic partner? YesNo





  Are any of the aforementioned animals fixed?YesNo

  Other household/family issues:

  Type of Residual Dwelling:  OwnRent
  Type of neighborhood: UrbanSuburbanRural

  Do you have a secure yard? NoYes (Describe below:)



Tell me how you know about Basenjis:



  Have you owned a Basenji before?YesNo

  Have you seen a Basenji in the flesh before?YesNo


Initial Preferences, if you have any:

  Preferred Sex:     Age:     Color:


  Competitive potential:

  Please note here any special expectations or concerns that you may have:

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