| Date & Referral Source | |||||||
| State: | Date of Application: | 12/20/2017 | 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: |
Male | Color preferred: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
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 | |||||||
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Who is this dog for? |
Myself! | ||||||
Why do you want a Pembroke? |
I am passionate about adopting a Pembroke because, in my opinion, they are the breed which represents the best of all worlds: high energy & able to romp & play, so adorable it hurts, & willing to chill at home & be snuggly lovebugs! I have done quite a bit of research & am confident that my personality would mesh perfectly with a Pembroke's. | ||||||
Activities planned with Pembroke: |
I am equal parts homebody & adventurer, & hope to someday find the perfect Pembroke to accompany me in both aspects! I love exploring new places in Minneapolis & look forward to obedience training, walks in the park, & some boisterous games of fetch, while also spending plenty of time at home playing & cuddling. I would love to socialize my pup with other dogs & hopefully make some new human friends through a puppy playgroup of sorts as well! | ||||||
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 firmly believe in the importance of clear communication–with both people & animals! I would identify the mistake, discipline as necessary, & reinforce the desired positive outcome. | ||||||
Discipline: |
As a hopeful first time dog owner, I plan to work extensively with a trainer to cultivate a healthy & productive relationship with my pup by establishing clear boundaries & disciplinary patterns. | ||||||
Where would Pembroke spend the majority of the time: |
With me in my apartment! | ||||||
Discipline: |
As a hopeful first time dog owner, I plan to work extensively with a trainer to cultivate a healthy & productive relationship with my pup by establishing clear boundaries & disciplinary patterns. Where would Pembroke spend the majority of the time: With me in my apartment! |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Typically, there are not. I work a full time job weekdays from 9:00am–5:00pm & am home in the evenings. My younger sister, who is my roommate, is occasionally home during the day, but it depends on her work schedule. | ||||||
Where would dog eat? |
Food & water dishes in the kitchen | ||||||
Where would dog sleep: |
He will have access to his crate as well as a cozy bed! | ||||||
Play & exercise: |
I plan to prioritize my pup's mental & physical health by walking him daily, engaging in active playtime daily, & connecting with other dog owners for socialization opportunities as often as possible. | ||||||
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: |
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? |
Yes | ||||||
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Description of yard: |
n/a | ||||||
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? |
Lauren Omernik | ||||||
Willing to train children? |
n/a | ||||||
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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? |
At this time, I plan to adopt a single Pembroke, but would certainly work towards a resolution should I have a multi-pet situation arise in the future. | ||||||
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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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