Date & Referral Source | |||||||
State: | Date of Application: | 10/08/2017 | 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: |
Male, Either a Male or a Female | Color preferred: |
Red Headed Tri | Activity level: |
Couch Potato, Outgoing, Quiet |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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 | |||||||
Who is this dog for? |
Myself – I am a single 29 year old male who works an office job in Chicago. I am looking for a companion / therapy dog (CGC). My workplace allows pets in the office and I would be bringing my potential pup to work during the week. | ||||||
Why do you want a Pembroke? |
A friend of mine has a pembroke that is very friendly, quite, and follows her around all the time. I really enjoy the companionship that her dog brings to her. Pembrokes are very intelligent and learn quickly. I love how active they can be and the attention they desire when being pet. | ||||||
Activities planned with Pembroke: |
I am looking for a companion dog. I am a smoker, so it would be therapeutic to take my pembroke out on long walks, and to the park on weekends. I work in the loop and have a workspace that allows pets in the office. I have three co-workers that the pembroke would interact with on a daily basis. There are often other dogs there as well, as well as many other office inhabitants. Its a co-working space so there are many small companies in one large office space. | ||||||
Aware that Pembrokes are busy, noisy dogs? |
Yes | ||||||
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 would contact the pembroke corgi club and ask for advice. | ||||||
Discipline: |
I've never owned a dog before or been raised with one. I would seek training for both myself and the dog at a formalized school. | ||||||
Where would Pembroke spend the majority of the time: |
Pembroke would spend most of its time in the office environment, at home, and walking around the neighborhood. | ||||||
Discipline: |
I've never owned a dog before or been raised with one. I would seek training for both myself and the dog at a formalized school. Where would Pembroke spend the majority of the time: Pembroke would spend most of its time in the office environment, at home, and walking around the neighborhood. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes – I have a roommate, but the dog would mainly be with me in the office. | ||||||
Where would dog eat? |
We have a sunroom in our apartment that would be our corgi's dedicated room. | ||||||
Where would dog sleep: |
I would get a dog bed for my corgi in the same room, or he or she can sleep in the sunroom in the summer months. | ||||||
Play & exercise: |
I am looking forward to taking walks with my corgi a few times a day for a minimum of fifteen minutes. On the weekends, we would spend more time together in the park. If I had too many commitments, I would get a dog walker or take my corgi to a day care so it would get the activity it needs. I do not want an upset dog. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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? |
Wooden fence with a gate around the back of it. Small area, 300 square feet. Shared with neighbors who also have dogs. | ||||||
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 | ||||||
Description of yard: |
No fixtures | ||||||
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. | ||||||
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? |
Daniel Berrocal | ||||||
Willing to train children? |
No plans on having children in the near or long term future. Single man. | ||||||
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? |
No Pets | ||||||
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. | ||||||
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: |