| Date & Referral Source | |||||||
| State: | Date of Application: | 01/02/2018 | Referred by: | Friend | |||
| 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, 10 years + | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
We have a large fenced-in backyard and our adult son, Chris, is home much of the day to help care for and enjoy our Pembroke. We have had quite a few dogs over the last 15 years or so, including a Lancashire Healer. Chris is especially interested in a Corgi. | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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| Dog 2 | |||||||
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| Dog 3 | |||||||
Dog 3 name: |
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| Dog 4 | |||||||
Dog 4 name: |
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| Questions Regarding Motivation for Adopting and Intentions | |||||||
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Who is this dog for? |
Our family. | ||||||
Why do you want a Pembroke? |
Our former next-door neighbor had a Pembroke and Chris became very attached to him. Chris appreciates their loyalty, how good they are with people and how much fun they are. Chris does a fair amount of volunteering at our local Humane Society, giving him contact with many breeds. Corgis are his favorite. He also likes their size. | ||||||
Activities planned with Pembroke: |
Fetch in the back yard and trips to the local dog parks would be the main activities.. | ||||||
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: |
For some mistakes a firm, but calm "No" or other consistent and clear verbal command can be constructive. For mistakes that could result in harm, diverting attention or distracting can be helpful. For other, less consequential mistakes, ignoring it can be the best way to handle it. | ||||||
Discipline: |
Primarily positive reinforcement with positive attention, affection or treats. Our Pembroke would probably be crate trained for housebreaking. | ||||||
Where would Pembroke spend the majority of the time: |
In our house or, in good weather and when one of us were home, our backyard. Primarily wherever we are (especially Chris). He or she would probably sleep in a crate. | ||||||
Discipline: |
Primarily positive reinforcement with positive attention, affection or treats. Our Pembroke would probably be crate trained for housebreaking. Where would Pembroke spend the majority of the time: In our house or, in good weather and when one of us were home, our backyard. Primarily wherever we are (especially Chris). He or she would probably sleep in a crate. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Chris is here quite a bit during workdays. | ||||||
Where would dog eat? |
We've usually placed their bowls in our kitchens. | ||||||
Where would dog sleep: |
In a crate in our kitchen. | ||||||
Play & exercise: |
Playing fetch and romping around in the backyard (about 3/4 of an acre). Chris can do several play / exercise times a day. Lisa and Paul will also want to spend time doing so. We also have friendly neighbor dogs who may come by for romps (if that works well). | ||||||
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? |
Our backyard (3/4 acre) is completely fenced in with a tall wooden fence. | ||||||
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: |
Big, fenced in backyard with deck. There is a hot tub with a substantial cover. | ||||||
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? |
Chris | ||||||
Willing to train children? |
We do not have children in our home, but are very willing to ensure that visiting children treat all animals well. | ||||||
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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? |
We currently have no animals in our home and have always limited ourselves to one dog at a time. | ||||||
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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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