Date & Referral Source | |||||||
State: | Date of Application: | 10/13/2017 | 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Red & White, Sable & White | 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 | |||||||
Who is this dog for? |
myself | ||||||
Why do you want a Pembroke? |
I have a corgi right now who is 13 and was a rescue. I got him when he was around 2, and he has been the best and most faithful dog ever. I love that corgis are intelligent and independent. I love that they are funny. My dog became ill this week, and I have to have him put down tomorrow. I can't imagine my life without him, but I think giving love to a new corgi would help. | ||||||
Activities planned with Pembroke: |
We would walk a lot. I would also like to be able to travel and camp. | ||||||
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? |
Yes | ||||||
Vet contact info: |
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Will handle mistakes Pembroke makes like this: |
I have found that positive rewards work best with corgis. Reinforce good behavior and redirect with mistakes. | ||||||
Discipline: |
I always try to redirect. Occasionally, I have had to be quite firm because my corgi could get a little pushy from time to time. | ||||||
Where would Pembroke spend the majority of the time: |
With me! In the house or with me int he yard, or walking the neighborhood. | ||||||
Discipline: |
I always try to redirect. Occasionally, I have had to be quite firm because my corgi could get a little pushy from time to time. Where would Pembroke spend the majority of the time: With me! In the house or with me int he yard, or walking the neighborhood. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No, but my parents have been pretty faithful about walking my dog at lunch time. As a teacher, I have summers off and other vacations to spend with my dog. | ||||||
Where would dog eat? |
In my kitchen | ||||||
Where would dog sleep: |
In a dog bed, or wherever the dog feels most comfortable. | ||||||
Play & exercise: |
Typically, I find that corgis love daily walks. They also enjoy time to roam in the yard. It depends on the dog and its age how much playing and exercising. But I am a regular walker. | ||||||
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? |
I have a chain link fence around my back yard. | ||||||
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 | ||||||
Description of yard: |
My yard is pretty typical–trees, a raised garden, but no swimming pool. | ||||||
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? |
Anne Keller | ||||||
Willing to train children? |
I have no children, but I do have children who visit from time to time. I always explain to them how to treat my dog with respect and distance. My corgi was not particularly fond of children, but he would tolerate them if given some distance. | ||||||
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 | ||||||
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: |