Date & Referral Source | |||||||
State: | Date of Application: | 02/12/2018 | 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: |
Any age | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Other (Please describe in the box below.) |
Other preferences: |
|||||||
Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
Dog 1 |
|||||||
Dog 1 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is this dog now? |
|||||||
Dog 2 | |||||||
Dog 2 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is the dog now? |
|||||||
Dog 3 | |||||||
Dog 3 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is dog now? |
|||||||
Dog 4 | |||||||
Dog 4 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is this dog now? | |||||||
Questions Regarding Motivation for Adopting and Intentions | |||||||
Who is this dog for? |
Myself. | ||||||
Why do you want a Pembroke? |
My previous job was a dog groomer at Petco; However with that being said I do not know the corgi personality that well. I do know they like to shepherd so I am making the assumption that their personality is similar to a herding group like a Shetland sheepdog. I would like to adopt this breed because I have had experience with herding group animals before, and I am genuinely interested in getting to know the corgi personality. | ||||||
Activities planned with Pembroke: |
Walking, we have a dog beach, it depends on the activity level of the individual dog. | ||||||
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 |
||||||
Do you have a veterinarian? |
Yes | ||||||
Vet contact info: |
|||||||
Will handle mistakes Pembroke makes like this: |
Positive reinforcement | ||||||
Discipline: |
Positive reinforcement | ||||||
Where would Pembroke spend the majority of the time: |
With me, during days I would work I would either drop the dog off at my parents or have doggie daycare | ||||||
Discipline: |
Positive reinforcement Where would Pembroke spend the majority of the time: With me, during days I would work I would either drop the dog off at my parents or have doggie daycare |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Only me | ||||||
Where would dog eat? |
In the kitchen | ||||||
Where would dog sleep: |
With me | ||||||
Play & exercise: |
Walks, dog beach | ||||||
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? |
6 feet all around | ||||||
Living arrangements: |
Own home | ||||||
Landlord info: |
|||||||
May we contact your landlord? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
Empty backyard surrounded by fence, some a table and chairs, and a locked tool shed | ||||||
Household members: |
|||||||
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? |
Lauren | ||||||
Willing to train children? |
I do not have any | ||||||
Any allergies? |
No one is allergic. | ||||||
Current pets: |
|||||||
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 | ||||||
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: |