| Date & Referral Source | |||||||
| State: | Date of Application: | 08/22/2017 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
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? |
Myself | ||||||
Why do you want a Pembroke? |
The only dog I ever owned was a Pembroke Corgi. I first fell in love with their little bodies and big ears. The say pets are like their owners, I guess if I had been a dog it would be a corgi. I'm fun, spunky, loving, loud, hard headed, and sometimes I have a bad attitude. Plus, they really are big dogs in little dog bodies. I've had family dogs growing up, but no other dog has ever been so loyal and shown so much love and devotion to me like a Corgi. | ||||||
Activities planned with Pembroke: |
I'd take them for walks, find a nice dog park so I can socialize my corgi as much as possible. If it isn't to hot or to cold, I enjoy driving and it's always fun when you have a companion. | ||||||
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? |
No | ||||||
Vet contact info: |
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Will handle mistakes Pembroke makes like this: |
I guess it depends on what the mistake. I wouldn't punish them, mistakes happen. If I felt it wasn't a mistake I would use my stern voice and tell them "no" | ||||||
Discipline: |
I go more for the stern voice. Say "no" , show them what they did wrong and "No, that's bad". | ||||||
Where would Pembroke spend the majority of the time: |
In the house free to roam | ||||||
Discipline: |
I go more for the stern voice. Say "no" , show them what they did wrong and "No, that's bad". Where would Pembroke spend the majority of the time: In the house free to roam |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No | ||||||
Where would dog eat? |
In the kitchen | ||||||
Where would dog sleep: |
Hopefully in my room, but they will be free to roam the house. | ||||||
Play & exercise: |
Go for walks, play fetch in the backyard, play fetch in the house. When they want to play someone will be there to play with them | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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Fenced yard? |
Yes, I have a fenced in yard. | ||||||
Willing to pick up dog waste? |
Yes, I will clean up after my dog. | ||||||
Willing to use a crate? |
6 ft. high wooden fence. Just put in last summer. It closes off the whole backyard. | ||||||
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: |
Large, with a small patio that has a table, chairs, and grill on it. A few evergreen bushes and the rest is grass | ||||||
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? |
Elyse Ratkowski | ||||||
Willing to train children? |
I don't have any children, but if I did I would | ||||||
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Any allergies? |
No one is allergic. | ||||||
Current pets: |
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Current pets dog friendly? |
Yes, all of our current pets are friendly toward dogs. | ||||||
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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