| Date & Referral Source | |||||||
| State: | Date of Application: | 06/18/2018 | 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: |
Any age | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Outgoing, Quiet, Playful, Energetic |
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? |
Our Family – There are the two of us/Mom (Audra) & Dad (Jamie) and our daughter Gretchen (17 1/2) we have a son in college (Jamie Jr.) | ||||||
Why do you want a Pembroke? |
I have been researching the PWC for about 5 years. Our dog of 15 years just died this past Friday. I have been telling my family that I wanted a Corgi for several years. They are so cute, smart, great size for our family. I love training, walking and the companionship of a dog. | ||||||
Activities planned with Pembroke: |
I would take them walking, boating with us, training classes, etc. | ||||||
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: |
Well that isn't a clear answer. There are different kinds of mistakes that would warrant different responses. I have trained several dogs, I started as a child taking our poodles in 4-H, I took two to the state fair as a child. When I became an adult my husband and I trained and loved Rottweilers and I did the obedience training and he did the confirmation. I put Titles on both dogs and Companion Dog Certifications on both. It is crucial to train a dog in order for them to know what you expect. They deserve that. | ||||||
Discipline: |
Method? I am not sure what you mean by method. When an animal does something that you have ask them to do the deserve a reward wether it is a good dog, a pet or a treat. They deserve correction with your voice or change of their attention or what is needed as well. | ||||||
Where would Pembroke spend the majority of the time: |
With me. I stay home. | ||||||
Discipline: |
Method? I am not sure what you mean by method. When an animal does something that you have ask them to do the deserve a reward wether it is a good dog, a pet or a treat. They deserve correction with your voice or change of their attention or what is needed as well. Where would Pembroke spend the majority of the time: With me. I stay home. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
yes, me | ||||||
Where would dog eat? |
What you recommend. | ||||||
Where would dog sleep: |
In a crate | ||||||
Play & exercise: |
We would walk daily. We would socialize with our friends dogs, and take to obedience classes. | ||||||
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? |
I have a fenced yard that is surrounded with arborvitaes and a gated driveway. | ||||||
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 a front yard that is fenced and no 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? |
Audra M Brockway | ||||||
Willing to train children? |
Yes | ||||||
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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? |
Don't have any other pets | ||||||
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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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