| Date & Referral Source | |||||||
| State: | Date of Application: | 08/09/2017 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Female | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Energetic |
Other preferences: |
I just lost my Pembroke, Stella, and feel this breed is perfect for me. I live alone on a farm. My husband died a year and half ago. I still have a few cattle but they are also cared for by a hired person. I am outside frequently and get plenty of exercise and walk daily with my dog. My dogs are my constant companion, both inside and out. I have raised dogs from puppy stage to rescue adults. | ||||||
| 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? |
myself-Marilyn | ||||||
Why do you want a Pembroke? |
As I previously stated, my last dog, Stella was a Pembroke. She was given to me by a co worker who could no longer care for her. When I still worked she was with my husband on the farm both inside and out and always slept indoors by our bed. I retired when he got cancer and spent her time primarily with me. I love her energy, attitude, intelligence, spunk, happiness, and joy of living. She was a farm dog but a great inside companion. I know some may consider Pembroke a bit needy but to me they are intelligent and perceptive. | ||||||
Activities planned with Pembroke: |
Living on a farm there are a variety of activities depending on the season. Regardless of the weather- except perhaps pouring rain- there are daily walks, per se, feeding animals, checking cows in the pasture and woods, using a mule-a seated 4 wheeler -to do various jobs, going down to my pond where the dog can splash on the edge as I swim in it, riding to town a few miles away for a short errand, playing in the house and petting, resting and sleeping by my side but not in the bed. | ||||||
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 tell them of the mistake in a voice different than normal and that it was not the way to be. | ||||||
Discipline: |
verbal, positive reinforcement | ||||||
Where would Pembroke spend the majority of the time: |
with me depending on where I was | ||||||
Discipline: |
verbal, positive reinforcement Where would Pembroke spend the majority of the time: with me depending on where I was |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
yes | ||||||
Where would dog eat? |
I have an area in my kitchen set up for the corgi | ||||||
Where would dog sleep: |
I have 3 dog beds-one in the living room, one in the bedroom by my bed, and one in my screen porch | ||||||
Play & exercise: |
The corgi will get much exercise. Walking, exploring would be the primary form outside. | ||||||
How will you exercise your dog? |
On leash | ||||||
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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: |
Own home | ||||||
Landlord info: |
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May we contact your landlord? |
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Lease allow dogs: |
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Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
farmhouse and out buildings with big yard, not near a road | ||||||
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? |
Marilyn Campbell | ||||||
Willing to train children? |
of course | ||||||
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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? |
yes | ||||||
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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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