| Date & Referral Source | |||||||
| State: | Date of Application: | 04/19/2018 | Referred by: | Other | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
| Address | |||||||
| Street: | |||||||
| City: | State: | Zip: | |||||
| Type of Dog Wanted | |||||||
Ages interested in: |
1 year – 3 years, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
We have one cat. We both work full-time, but my husband comes home most days for lunch. | ||||||
| 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? |
This Pem is for myself (Liz) and my husband Justin. | ||||||
Why do you want a Pembroke? |
Corgis are so funny yet smart. I love their personalities. I first fell in love with the breed when my family adopted a corgi when I was in college. I love that they're big dogs in a smaller package. I have done extensive research on the breed and know several people with corgis, have been around them, and follow corgi groups on Facebook which provide lots of info, details, and quirks specific to the breed. | ||||||
Activities planned with Pembroke: |
Regular walks and trips to the local dog park. We would like to become more active and hope that a dog will encourage that. If it was clear the dog needed more exercise or stimulation, we would absolutely make that happen. I would be willing to look into agility training if I felt the dog was right for it. | ||||||
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: |
We will correct the dog, but not meanly. We'll redirect to the preferred behavior and then use positive reinforcement for the proper behavior. | ||||||
Discipline: |
I subscribe to the positive reinforcement methods and would follow training and discipline methods like Victoria Stilwell teaches. No hitting or anything, but rather redirection and praise for doing the right behavior. | ||||||
Where would Pembroke spend the majority of the time: |
Either in the house or in the backyard. The backyard is fenced and we will have a kennel on the covered porch with a bed in it. When the weather is nice, we would leave the dog in the backyard while we're out, but would make accommodations to be home for potty breaks if the weather was bad. We'd love to be able to take the dog with us when we're running errands and whatnot. | ||||||
Discipline: |
I subscribe to the positive reinforcement methods and would follow training and discipline methods like Victoria Stilwell teaches. No hitting or anything, but rather redirection and praise for doing the right behavior. Where would Pembroke spend the majority of the time: Either in the house or in the backyard. The backyard is fenced and we will have a kennel on the covered porch with a bed in it. When the weather is nice, we would leave the dog in the backyard while we're out, but would make accommodations to be home for potty breaks if the weather was bad. We'd love to be able to take the dog with us when we're running errands and whatnot. |
||||||
|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
On the weekends, yes. During the week my husband often comes home for lunch. | ||||||
Where would dog eat? |
In our kitchen | ||||||
Where would dog sleep: |
Wherever they'd like in the house – a dog bed, our bed, etc. | ||||||
Play & exercise: |
We will take daily walks and have play time in or outdoors depending on the weather. There are several dog parks in our city and we would take the dog on the weekends, assuming it got along well with other dogs. | ||||||
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? |
Aluminum fencing, about 5 feet high. Posts are close enough that a corgi would not be able to fit through. | ||||||
Living arrangements: |
Own home | ||||||
Landlord info: |
|||||||
May we contact your landlord? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
|
Description of yard: |
Medium sized yard. Fenced with a covered porch with 2 steps up to the porch. No pool or play set or anything. Patio furniture on the porch. | ||||||
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? |
My husband and I will share these duties | ||||||
Willing to train children? |
We do not have children and do not want children. | ||||||
|
Any allergies? |
No one is allergic. | ||||||
Current pets: |
|||||||
|
Current pets dog friendly? |
|||||||
Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
Yes. We are not sure how our cat will react to a dog, as she has never been around one in the time we've had her (5+ years). But, we will make every effort to make sure there is harmony between pets. We don't want either animal to be anxious or fearful of the other. | ||||||
|
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: |
|||||||