| Date & Referral Source | |||||||
| State: | Date of Application: | 08/04/2017 | Referred by: | Website | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
| Address | |||||||
| Street: | |||||||
| City: | State: | Zip: | |||||
| Type of Dog Wanted | |||||||
Ages interested in: |
1 year – 3 years, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
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| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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Dog 1 name: |
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Dog description: |
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How long owned? |
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Where is this dog now? |
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| Dog 2 | |||||||
Dog 2 name: |
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Dog description: |
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How long owned? |
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Where is the dog now? |
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| Dog 3 | |||||||
Dog 3 name: |
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Dog description: |
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How long owned? |
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Where is dog now? |
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| Dog 4 | |||||||
Dog 4 name: |
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Dog description: |
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How long owned? |
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| Where is this dog now? | |||||||
| Questions Regarding Motivation for Adopting and Intentions | |||||||
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Who is this dog for? |
Amanda and Alex | ||||||
Why do you want a Pembroke? |
We are very passionate about being able to provide a dog with a loving and safe home and that is why we want to adopt. We are specifically looking at the Pembroke Welsh Corgi breed because of their affectionate and loving temperament. We want a dog that is family orientated and likes to be around people. They are easy to train and are very intelligent. Their size is ideal of our apartment living. We have researched that this breed is a good watchdog and stays alert. They behave well around strangers, small children, and other pets. We learned it is important to keep their weight down or it can lead to medical issues. We have been looking for a Pembroke for a while to make an addition to our family. We find spending time and taking care of dogs very rewarding. We are missing the love and affection of a Pembroke in our home. | ||||||
Activities planned with Pembroke: |
We would be able to provide the Pembroke with a lot of family time and surround it with other dogs to socialize and play with. We are very active by taking walks and exercising. We travel up north a lot in the summer so our Pembroke would get the opportunity to roam and swim. We have many family members with dogs who could assist in the Pembroke's care. We want to take the Pembroke to the dog park at least a couple times a week. We would provide the best possible care for the Pembroke by taking it on regular vet visits, watching its diet, providing exercise and of course a ton of love and affection. We have attended training with other dogs and would be able to train the Pembroke. | ||||||
Aware that Pembrokes are busy, noisy dogs? |
Yes | ||||||
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Money for basic care? |
Yes | ||||||
Money for unforeseen medical expenses? |
Yes | ||||||
Willing to house train? |
Yes Willing to do formal training? Yes |
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Do you have a veterinarian? |
Yes | ||||||
Vet contact info: |
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Will handle mistakes Pembroke makes like this: |
I would ensure to correct the behavior through training and repetition. | ||||||
Discipline: |
verbal, and correct the behavior and reward | ||||||
Where would Pembroke spend the majority of the time: |
With us at our apartment or out and about exercising/playing | ||||||
Discipline: |
verbal, and correct the behavior and reward Where would Pembroke spend the majority of the time: With us at our apartment or out and about exercising/playing |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No. Could bring Pembroke to family members house to play during the day while at work. | ||||||
Where would dog eat? |
At home | ||||||
Where would dog sleep: |
In our bed or bedroom. | ||||||
Play & exercise: |
We spend a lot of time outside and being active and we would take the corgi along. Also bring them to the dog park and the cabin to swim. We could provide 10-20 hours a week on exercise. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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Fenced yard? |
No, I don’t have a fenced in yard. | ||||||
Willing to pick up dog waste? |
Yes, I will clean up after my dog. | ||||||
Willing to use a crate? |
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Living arrangements: |
Rent/lease home | ||||||
Landlord info: |
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May we contact your landlord? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
Don't live in a house | ||||||
Household members: |
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Everyone in household agrees about adopting a corgi? |
Yes, everyone agrees and wants to adopt a Pembroke Welsh Corgi. | ||||||
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May we do a home visit? |
Yes, I will allow LPWCR representatives to inspect my home prior to allowing me to adopt a Pembroke. | ||||||
Who will be responsible for the adopted corgi’s care? |
Amanda | ||||||
Willing to train children? |
No children | ||||||
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Any allergies? |
No one is allergic. | ||||||
Current pets: |
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Current pets dog friendly? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
No current pets | ||||||
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Lifetime commitment to Pembroke? |
Yes, I am willing to commit to this dog for the rest of its life. | ||||||
Return to Lakeshore if unable to care for Pembroke? |
Yes, I will only surrender my adopted corgi to LPWCR if I am unable to care for it. | ||||||
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Understand no guarantees? |
Yes, I understand that there are no guarantees regarding the condition, health, behavior or personality of the Pembroke I adopt. | ||||||
Carefully considered the pluses and minuses of adopting a pet? |
Yes, I have carefully thought out my decision to adopt a Pembroke and am willing to deal with the consequences. | ||||||
Personal references: |
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