| Date & Referral Source | |||||||
| State: | Date of Application: | 05/30/2018 | 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 + | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, 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? |
Tara. She would like a companion for Clyde, a 4 year old rescue from the local shelter, and Ella, a 13 year old Newfie. Clyde has a lot of playful energy and Ella is winding down and has mobility issues. Tara is used to having 3 dogs, having just lost FeeBee, a 15 ½ year old Shi Tzu in January. | ||||||
Why do you want a Pembroke? |
I love how full of personality they are and full of playfulness. I have always loved corgis and the way they are clownish. I know they can be full of energy at times, shed a lot, and are a big dog in a little dog’s body. I have had a lot of big dogs and now am graviating to littler ones, but a corgi is more manageable for me (I have chronic pain). A corgi will bring the playful energy into our home that Clyde needs, as Ella is an ancient Newf. Ella cannot and should not be physically active due to her hip and knee pain and mobility problems. | ||||||
Activities planned with Pembroke: |
The first thing I will do is get him or her into some training so we can bond. I know that corgis are smart and can be bossy so it’s important that he or she know who is boss (me) and that we have some communication. I believe in reward oriented training and have 2 wonderful trainers that we have used with Clyde in the past. Our corgi would go to the park, on walks, on day trips to beach towns, and to the store (when possible). Given the right personality, I would also consider therapy dog training. | ||||||
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: |
It depends on the “mistake”. If it chews up my couch, I would try to figure out why. If I catch a dog in the act of doing something bad, I yell “No!” Like when Clyde gets into my garden. If the “mistake” is peeing in the house, you can only correct them if you catch them in the act. You get a lot of mileage from praise when they do good and just have to watch them a lot to catch the bad behavior. | ||||||
Discipline: |
I yell NO. If a dog is very naughty, they go to the laundry room which is on the first floor of our house. I use it as a time out. As I have gotten older and wiser with my dogs I do not find it necessary to hit a dog, as was shown to me by my parents with my childhood dogs. | ||||||
Where would Pembroke spend the majority of the time: |
With me, Clyde, and Ella at home. | ||||||
Discipline: |
I yell NO. If a dog is very naughty, they go to the laundry room which is on the first floor of our house. I use it as a time out. As I have gotten older and wiser with my dogs I do not find it necessary to hit a dog, as was shown to me by my parents with my childhood dogs. Where would Pembroke spend the majority of the time: With me, Clyde, and Ella at home. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. I do not have a job outside the home right now and have been a stay at home mom for over 20 years. | ||||||
Where would dog eat? |
In the kitchen or dining room. Initially away from the other two dogs. | ||||||
Where would dog sleep: |
If house trained, the corgi would sleep wherever he or she liked. | ||||||
Play & exercise: |
Daily walkies and playing outside and inside with Clyde. We have an invisible fence as our subdivision doesn’t allow us to have a physical fence, but even so the dogs are never outside by themselves, they are always being watched. I take Clyde out in the backyard and play fetch and he likes to sit outside with me as I garden. We go on nature hikes too. | ||||||
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: |
We have neighbors on either side but not behind us, as our property abuts a natural, undevelopable area, with deer, a marsh, lots of squirrels, chipmunks, and birds. We cannot have a physical fence but we have an invisible one for the dogs. We have flower gardens in front and back and a lot of trees for summer shade. | ||||||
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? |
Tara | ||||||
Willing to train children? |
My children are adults. I am careful with my dogs and little children because not everyone is gentle with dogs or comfortable with dogs. This is why I like taking the dogs into the community with us when we can do it right, to get people comfortable with them. | ||||||
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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? |
Of course! | ||||||
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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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