| Date & Referral Source | |||||||
| State: | Date of Application: | 04/08/2018 | Referred by: | Friend | |||
| 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
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| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
For both of us. | ||||||
Why do you want a Pembroke? |
I have done quite a bit of research on Corgis and absolutely love their energy & temperament . I currently own a Cairn Terrier who is about 20 pounds and me and my boyfriend both feel that we don't want a dog smaller than 15 pounds and no bigger than 40 pounds. We have a large fenced in backyard that we allow our dog to run around so there would be plenty of area for exercise. I love their outgoing and individual personality and feel they would be a great addition to our little family. | ||||||
Activities planned with Pembroke: |
Lots and lots and lots of tennis ball catch, 1-1/2 mile walks 2x a day (at least), swimming during the summer months, hiking / trail walking. | ||||||
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: |
Mistakes happen and it's hard to discipline an animal who can't fully comprehend the situation or know why you are mad. I will figure out how to avoid the mistake in the future (i.e. if they made a mess in the house, allow for more frequent potty breaks; if they chew on shoes, move the shoes out of reach, etc.) | ||||||
Discipline: |
Nothing physical but primarily I will "ignore" for a short period of time such as not giving them extra belly rubs or having them sit in a timeout however I will never ignore them to the point of making them hold their potty's or not feed them, etc. It would be not giving them those extra rewards like treats for about 30 minutes. Than I would work with them on whatever it is that is a bad habit to try to help them understand what is right and wrong. | ||||||
Where would Pembroke spend the majority of the time: |
Wherever! Our home is their home – they can roam all over the house and whenever they would need to go outside they are more than welcome to stay out for as long as they'd like. | ||||||
Discipline: |
Nothing physical but primarily I will "ignore" for a short period of time such as not giving them extra belly rubs or having them sit in a timeout however I will never ignore them to the point of making them hold their potty's or not feed them, etc. It would be not giving them those extra rewards like treats for about 30 minutes. Than I would work with them on whatever it is that is a bad habit to try to help them understand what is right and wrong. Where would Pembroke spend the majority of the time: Wherever! Our home is their home – they can roam all over the house and whenever they would need to go outside they are more than welcome to stay out for as long as they'd like. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No but we have neighbors who let the dogs out in the middle of the day. | ||||||
Where would dog eat? |
In the kitchen. | ||||||
Where would dog sleep: |
In bed / on couch / in crate – wherever they feel most comfortable. | ||||||
Play & exercise: |
I have neighbors who let our dogs out during the middle of the day and I would take them for a walk in the morning and at night when I get home from work – also lots and lots of ball time after I get hoem | ||||||
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? |
Half of it is a Privacy fence that runs to the garage and over and there is a second half of the yard that is fenced in with a chain fence that is about 5 feet tall. | ||||||
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: |
Large backyard with 1 garage & 1 shed in front half. | ||||||
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? |
Kelsie Meade | ||||||
Willing to train children? |
N/A – will not have kids. | ||||||
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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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