SIENNA Basenjis
  
 ADOPTION APPLICATION

Thank you for your interest in Sienna Basenjis.  Please take the time to answer the below questions completely.

  How did you hear about Sienna 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:   Cell Phone: 

  Type of work: 

  


Tell me about your household:

  Do you have a domestic partner? YesNo

  

  

  

  

  Are any of the aforementioned animals fixed?YesNo

  If "yes" for pets, do you currently have a Veterinarian?:
  

  Are there any family health 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:

  Temperament:

  Competitive potential:

  We understand the cost of a puppy is very important to your decision.
  Please note below what your expectation is for a puppy:
  

Besides routine care of yearly shots and maintenance, sometimes dogs need unexpected medical care. Some breeds have genetically inherited medical problems which may need care throughout their lifetime, or as a senior. Veterinary expenses at times can be very costly.

Would providing medical care to your dog be a problem when required? NoYes


  Please note here any other concerns you may have:
  


Thank you for taking the time to fill out our Application. 
Please click the "Submit" button