| Date & Referral Source | |||||||
| State: | Date of Application: | 07/02/2018 | 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: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
I also have two cats, and another corgi mix so it is important that the dog likes other animals. | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
Myself | ||||||
Why do you want a Pembroke? |
I currently have a corgi mix. He is protective, loyal, fearless, and is full of joy. He is playful loving to fetch rubber toys and will do so for hours. He loves to walk as do I and is up for any activity at any time, as well as cuddling on the couch in the evenings. I enjoy working breeds as they are highly intelligent. I understand that corgis as any working breed need a job to do. Generally speaking an older dog would be better for me, as I am older and don't have the energy level I once had. | ||||||
Activities planned with Pembroke: |
I like to walk with my dogs as well as play with them-whether it is a game of fetch or tug of war. I would also be willing to take my dog to agility classes if the dog enjoyed that activity. | ||||||
Aware that Pembrokes are busy, noisy dogs? |
Yes | ||||||
|
Money for basic care? |
Yes | ||||||
Money for unforeseen medical expenses? |
No | ||||||
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: |
I don't think dogs generally make mistakes. They may have behavioral quirks that need attention and training. | ||||||
Discipline: |
I find that positive reinforcement works the best. For instance, if a dog rushes to the door to jump up on guests, I would leash the dog when I was expecting company, and make them sit before I opened the door. The dog would receive treats(food, toy or praise) when they sat quietly when someone came in. IF the dog tried to jump up, I would tell it "no" and put it back into a sit, and when it sat quietly it would receive whatever motivator worked best. | ||||||
Where would Pembroke spend the majority of the time: |
Inside, sleeping on the couch no doubt. | ||||||
Discipline: |
I find that positive reinforcement works the best. For instance, if a dog rushes to the door to jump up on guests, I would leash the dog when I was expecting company, and make them sit before I opened the door. The dog would receive treats(food, toy or praise) when they sat quietly when someone came in. IF the dog tried to jump up, I would tell it "no" and put it back into a sit, and when it sat quietly it would receive whatever motivator worked best. Where would Pembroke spend the majority of the time: Inside, sleeping on the couch no doubt. |
||||||
|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No. My work is somewhat portable so I am not required to be gone all day. | ||||||
Where would dog eat? |
In the kitchen | ||||||
Where would dog sleep: |
In my bedroom | ||||||
Play & exercise: |
The dog would be out of the crate whenever I am home. I have a large fenced yard so it would have access to the yard when I am home. It would also have a play/pal with my corgi cross that loves to play. I also walk my dogs, Once the dog was well enough behaved to leave alone uncrated when I am not home that is what I would choose. | ||||||
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? |
6 foot wooden privacy fence | ||||||
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: |
Big fenced back yard with two mature trees, It is very shady. | ||||||
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? |
myself | ||||||
Willing to train children? |
NA | ||||||
|
Any allergies? |
No one is allergic. | ||||||
Current pets: |
|||||||
|
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? |
I can't accept a dog that is aggressive towards cats and other dogs. That's non negotiable. My cats are accepting of dogs though one would prefer not to have them around. Actually she would prefer not to have the other cat around either. Now that I think about it, she would probably happily dispense with me if she could figure out a way to keep her food bowl full. But she also isn't aggressive towards dogs. | ||||||
|
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: |
|||||||