Do you live in a: House Apartment Other

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:   Chain Link Wood Underground Electric Other (The more flexible you are the greater the chance of a perfect match.)

How old are you?

Do you have any children?  No Children Infants Over 6 Years Teenagers Grown Family

Are you? Married Single Engaged

Do you have roommates?  Yes No

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

If so, what kind? Dogs Cats Ferrets Rabbits Hamsters Mice Birds Lizards Reptiles Other

Have you ever been owned by a Basenji before? Yes  No

What traits are you looking for in a dog?

Why have you decided you would like a Basenji versus another breed?

Have you ever met a Basenji? Yes  No

Do you work  and if so, choose type of work? Work Full Time Work Part Time Retired Other

Are you interested in a male or female Basenji? Male Female

Do you have a colour preference? Red N White Black N White TriColor Brindle N White

Can you also give me a second/ third colour preference?   Red N White Black N White TriColor Brindle N White

Have you visited my web site www.beaubri.com to learn more about myself and Basenjis?

Yes  No

Have you visited the FAQ page? http://www.beaubri.com/FAQ.html Yes  No

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

If so, please submit your comments/suggestions below: