| Date & Referral Source | |||||||
| State: | Date of Application: | 07/26/2018 | 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: |
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: |
Any color | 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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| Dog 2 | |||||||
Dog 2 name: |
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Dog description: |
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How long owned? |
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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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| Questions Regarding Motivation for Adopting and Intentions | |||||||
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Who is this dog for? |
Our family and two kids (10 and 7). | ||||||
Why do you want a Pembroke? |
I grew up with corgis and have loved them all my life. We had a show dog (Ch. Roughhouse Pennington's Daryl) and two rescue sisters. My husband and I adopted a little boy (Ziggy) from Mary Matejeck (sp?) when we were dating. We recently lost him after a fabulous 13.5 yrs. He was an integral part of our family. We have two kids ages 10 and 7 and we would love to rescue a corgi (or two!). | ||||||
Activities planned with Pembroke: |
All the activities! Walks, playing, car rides, daily life. Ziggy was a part of our family and did everything with us. | ||||||
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: |
Gentle correction, redirection | ||||||
Discipline: |
Mostly redirection worked with our other dog, and lots of positive reinforcement and treats 🙂 | ||||||
Where would Pembroke spend the majority of the time: |
In our house, free if they can handle it or we can confine to one room, crate if we need to. | ||||||
Discipline: |
Mostly redirection worked with our other dog, and lots of positive reinforcement and treats 🙂 Where would Pembroke spend the majority of the time: In our house, free if they can handle it or we can confine to one room, crate if we need to. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
We both work outside the home and our kids are in school, so we are gone from about 9 until 4 most days during the week. My husband can come home for lunch to take a dog outside mid-day. | ||||||
Where would dog eat? |
Kitchen | ||||||
Where would dog sleep: |
In our bedroom or in a crate if needed | ||||||
Play & exercise: |
Our kids would give a corgi plenty of exercise! Our old corgi Ziggy never liked walks much, so we would play fetch and other games with him instead. Hide and seek always provides good mental stimulation too. And teaching tricks. We'd love a dog that liked to go on walks and would happily take morning and evening walks with him/her/them 🙂
It's worth noting that we do not currently have a fenced yard because Ziggy never roamed (he was 10 when we moved to this house). We plan on doing either a physical fence or an invisible fence when we get a new dog. |
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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 live on a quiet cul-de-sac with an above ground seasonal swimming pool and a small deck. We plan to fully fence the backyard or get an invisible fence when we get a new dog. | ||||||
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? |
Sarah and Jeff | ||||||
Willing to train children? |
They've always been around dogs, we had Ziggy when they were born. He was not the kind of dog who tolerated kids climbing on him and stuff, so they've always known to be respectful. | ||||||
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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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