| Date & Referral Source | |||||||
| State: | Date of Application: | 05/07/2018 | 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: |
1 year – 3 years, 3 years – 5 years, 5 years – 10 years, 10 years +, Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Quiet, Playful, Energetic |
Other preferences: |
I am active retiree who misses her Corgi | ||||||
| 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? |
Beloved companion | ||||||
Why do you want a Pembroke? |
I had a prefect little lady Corgi rescue found on a horse farm by my daughter. The Beagle wants to know what I can do for him. Corgi wanted to know what she coud do for me! | ||||||
Activities planned with Pembroke: |
Walk, run, travel, (have camper) | ||||||
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: |
Prevention is the cure. If she likes garbage, remove tempation. If she barks at another dog, tap her on the nose and say No. |
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Discipline: |
Since they all were rescues, they came with fear of squirt gun or fly swatter. So I would wave that. That is all I have ever had to do. | ||||||
Where would Pembroke spend the majority of the time: |
With me! As long as it is not too hot or too cold in the car, they go with me. I don't work any more so they will _not_ be left alone for 8-10 hours a day. | ||||||
Discipline: |
Since they all were rescues, they came with fear of squirt gun or fly swatter. So I would wave that. That is all I have ever had to do. Where would Pembroke spend the majority of the time: With me! As long as it is not too hot or too cold in the car, they go with me. I don't work any more so they will _not_ be left alone for 8-10 hours a day. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No, but my adult children will keep them if I ask. | ||||||
Where would dog eat? |
Good quqlity dog food. Our Corgi was susceptible to urinary infections, so bought her Nutro Ultra which contained blueberries and other ingredients good for urinary tract. She loved smoothies, so she would get her own little helping. | ||||||
Where would dog sleep: |
She can have her own bed, but can sleep with me if she wants to. | ||||||
Play & exercise: |
Walk, run, play. In Florida we have 1-acre dog park where she can roam free. To be shared with daughters 2 Australian Sheperds (her home) and my Beagle. Also there are area dog parks within easy driving distance. I aim for one short walk (half mile) and one long walk (2 miles) per day plus dog park time. | ||||||
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? |
In Florida we have one acre "dog park"/horse pasture in the yard. In Ohio I walk the dogs around 4 acres of woods, creek, pond,and lawn. | ||||||
Living arrangements: |
6 months each in Florida and Ohio in camping trailer. I am full time camper. | ||||||
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: |
In Ohio, a 1/4 acre pond. My Beagle taught himself to fish! In Florida, no pond or swimming pool. | ||||||
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? |
Self | ||||||
Willing to train children? |
Grandchildren are in college. No babies yet. I will be happy to teach children to care for dog. | ||||||
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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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