| Date & Referral Source | |||||||
| State: | Date of Application: | 05/07/2018 | 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: |
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: |
Red & White, Red Headed Tri, Sable & White | Activity level: |
Outgoing, Quiet, Playful, Energetic, Very Active |
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? |
Mainly for my wife and I, since my kids are out of the house | ||||||
Why do you want a Pembroke? |
We lost our Welsh Corgi that we had for 14 years. She passed away in October of last year. She was a intimate part of family (We pretty much didn't have a choice 🙂 ). I've had several different breeds of dogs through out my life, but I've never been so attached to a dog as I was with our Corgi. It has taken this long to actually start to get over the loss. I love how intelligent, loving, and energetic Corgi's are. One of our nicknames for ours was "Forever Puppy". I'm actually getting choked up writing this. I would love to have another one. I'm hoping to be able to adopt one. | ||||||
Activities planned with Pembroke: |
Catch, Chase (loved playing chase with our previous one. She would turbo around our basement at full speed while I tried to grab her…I never could), walks, and bike rides. I found bike rides were the only way to tire her. Their energy seems boundless. | ||||||
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: |
Stearn voice. make sure it was a face to face so it knows who the alpha is. Corgi's are smart, I found they "get it" very quickly. | ||||||
Discipline: |
Stern Voice. We have a wireless fence for outdoor boundaries | ||||||
Where would Pembroke spend the majority of the time: |
Most of the time indoors | ||||||
Discipline: |
Stern Voice. We have a wireless fence for outdoor boundaries Where would Pembroke spend the majority of the time: Most of the time indoors |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
My Wife is home typically 4 to 5 days a week | ||||||
Where would dog eat? |
Ours had its own bowl in the kitchen | ||||||
Where would dog sleep: |
Our previous Corgi had her own bed in the family room | ||||||
Play & exercise: |
We have 1/2 acre of yard for a dog to play in. We have lots of biking and walking in our neighborhood | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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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: |
mostly flat grass. We live in central illinois. Everything is flat. I have a pool, but it is above ground. Nothing dangerous outside | ||||||
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? |
Steve McHugh | ||||||
Willing to train children? |
My kids are adults. They know | ||||||
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Any allergies? |
No one is allergic. | ||||||
Current pets: |
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Current pets dog friendly? |
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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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