| Date & Referral Source | |||||||
| State: | Date of Application: | 01/02/2018 | Referred by: | Website | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
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| City: | State: | Zip: | |||||
| Type of Dog Wanted | |||||||
Ages interested in: |
3 years – 5 years, 5 years – 10 years | Gender preferred: |
Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Quiet, Playful, Energetic |
Other preferences: |
I typically rescue special needs dogs, also typically mixed breeds. Looking for a middle aged corgi or mix to join the fam. We had a corgi mix who passed away of adrenal cancer and Cushing’s disease in Oct. 2017 after a long battle. Our other dogs are a Shih Tzu mix and a beagle mix. | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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| Dog 2 | |||||||
Dog 2 name: |
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| Dog 3 | |||||||
Dog 3 name: |
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| Dog 4 | |||||||
Dog 4 name: |
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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? |
Me, my husband and our two other rescued mutts. (Small dogs) | ||||||
Why do you want a Pembroke? |
Our beloved Lucy who passed away in October was part Corgi. Interested in the breed because of how loving and wonderful she was. | ||||||
Activities planned with Pembroke: |
Walks, General play, (we have a giant basket of toys) 2 other dogs to play with, we do not have children, our dogs are our kids! | ||||||
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? No |
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Do you have a veterinarian? |
Yes | ||||||
Vet contact info: |
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Will handle mistakes Pembroke makes like this: |
We are very loving pet owners. If the dog goes potty on the floor we clean it up and immediately take the dog out. We don’t yell at our dogs but show them the correct spot to potty. Our others dogs are trained to stop barking by just showing them a squirt bottle. That is about as “mean” as we are and this rarely happens. Our dogs are also put in crates to eat so they get the correct amount of food and they also go in crates when we have visitors which is also very rare. | ||||||
Discipline: |
Just correct the behavior. Potty accidents are no big deal, just take the dog out immediately to show them where to go. If a barking issues arises we show a squirt bottle to them. If my beagle is getting too rough playing with my Shih Tzu, all I have to do is clear my throat with the “aathem” noise. | ||||||
Where would Pembroke spend the majority of the time: |
In our home with us. Snuggled on the couch and bed. | ||||||
Discipline: |
Just correct the behavior. Potty accidents are no big deal, just take the dog out immediately to show them where to go. If a barking issues arises we show a squirt bottle to them. If my beagle is getting too rough playing with my Shih Tzu, all I have to do is clear my throat with the “aathem” noise. Where would Pembroke spend the majority of the time: In our home with us. Snuggled on the couch and bed. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I work 4 days a week. On days when my husband or I will be gone longer than 4 hours he comes home to do potty breaks. With our work schedules the dogs are never alone more than 5 hours. | ||||||
Where would dog eat? |
In a crate. We separate our dogs for breakfast and dinner time because we feed them according to their diet needs. This is the only time they are crated unless we have too much company over. | ||||||
Where would dog sleep: |
Free range. Our dogs have dog beds and their own sofa. They are also welcome in bed with me if they want. We have doggy steps leading up to the big human bed. | ||||||
Play & exercise: |
Outside walks a few times a day. Always 1/2 hour of me or hubby playing with toys with them, we have a big long open floor plan for games of fetch! Our other dogs get the “zoomies” too, plenty of house to do zoomies! | ||||||
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: |
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: |
2 acres of land in the country. No fence but always on a leash and supervised. Our house is set way back from the road. We have never had a problem with a dog getting loose. I am way too OCD and my dogs are my kids, I will never let them loose or alone. | ||||||
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? |
My husband and I both take care of our dogs. | ||||||
Willing to train children? |
We do not and cannot have children. On the very rare occasion we have a child visitor we explain how to treat the dogs before they even see the dogs. Or sometimes the dogs are crated. | ||||||
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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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