| Date & Referral Source | |||||||
| State: | Date of Application: | 01/04/2018 | Referred by: | Website | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
| Address | |||||||
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| 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
The dog's activity level isn't as important to me as their health and well-being. I want to make sure the dog is happy in his/her new home. | ||||||
| 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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| 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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| Questions Regarding Motivation for Adopting and Intentions | |||||||
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Who is this dog for? |
Myself (companion pet) | ||||||
Why do you want a Pembroke? |
I have always loved this breed! I love their big ears and their short, stubby legs. I have friends that have/have had PWCs and I've only heard good things. My personal experiences interacting with these dogs has always been positive. I love being active with dogs and I'm fully aware that PWCs need a lot of exercise. I've done extensive research online and I think he/she'd be a perfect companion. | ||||||
Activities planned with Pembroke: |
Daily walks, rope tug, fetch in the backyard, etc. I have a large, fenced-in backyard (6ft wooden privacy fence) for the dog to run and play. | ||||||
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 would be sure to refrain from spanking/hitting, or anything that may scare or hurt the dog. I feel the best training method is positive reinforcement; to give rewards (food or play/praise) upon completion of a desired behavior. | ||||||
Discipline: |
In my experience, it is sometimes acceptable to scold a dog, but only if you catch them in the act of an undesired behavior. If you scold afterwards, the dog may not know why you're mad and your anger may make the dog afraid of you. The best form of training is positive reinforcement. This teaches the dog to engage in good behavior due to its reward (food, play and/or praise). | ||||||
Where would Pembroke spend the majority of the time: |
Most of the time would be spent inside the home, but I would make sure to dedicate the appropriate amount of outdoor activity. | ||||||
Discipline: |
In my experience, it is sometimes acceptable to scold a dog, but only if you catch them in the act of an undesired behavior. If you scold afterwards, the dog may not know why you're mad and your anger may make the dog afraid of you. The best form of training is positive reinforcement. This teaches the dog to engage in good behavior due to its reward (food, play and/or praise). Where would Pembroke spend the majority of the time: Most of the time would be spent inside the home, but I would make sure to dedicate the appropriate amount of outdoor activity. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No | ||||||
Where would dog eat? |
I would place the food bowl near his/her crate, on the floor. The crate would also be near the back door to the yard. | ||||||
Where would dog sleep: |
Either in my bed, or in his/her crate or dog bed; whichever the dog prefers. | ||||||
Play & exercise: |
I will make sure to devote sufficient time to run and play in the back yard (fetch, etc). Daily walks will also be a part of this. I can often work from home, so this will allow me more time to spend with the dog. | ||||||
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? |
6ft, wooden privacy fence. It completely fences in the 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 | ||||||
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Description of yard: |
I have a large, fenced-in back yard. There is a 6ft, wooden privacy fence. There is currently nothing else in the yard (no garage, no pool, no garden, etc.) at this time. | ||||||
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? |
Zac (myself) | ||||||
Willing to train children? |
N/A – I do not have any children. However, I would take all necessary measures to property teach young children how to interact with the dog should the situation arise. | ||||||
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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. Currently I have no pets, but I would take any measures necessary to make sure everyone gets along should I get an additional pet 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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