| Date & Referral Source | |||||||
| State: | Date of Application: | 09/01/2018 | Referred by: | Website | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
| Address | |||||||
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| 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: |
Couch Potato, 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 2 | |||||||
Dog 2 name: |
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Dog description: |
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| Dog 3 | |||||||
Dog 3 name: |
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| Dog 4 | |||||||
Dog 4 name: |
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Dog description: |
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| Questions Regarding Motivation for Adopting and Intentions | |||||||
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Who is this dog for? |
The new addition to the family would be for Christian Rennick. | ||||||
Why do you want a Pembroke? |
Christian had a corgi mix growing up and has always wanted another one. Both of us enjoy being outside and going for walks. Corgi’s are intelligent and loving. We both have done researching on all types of dogs and a corgi seems like a great fit. | ||||||
Activities planned with Pembroke: |
Walking. Parks. Christian use to play games with his older dog and wants to do that. | ||||||
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? |
No | ||||||
Vet contact info: |
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Will handle mistakes Pembroke makes like this: |
Saying “no” and “stop” to begin with. Depending on the behavior put them in a crate for a “time out”. Using corrective words with a negative tone of voice, showing negative body language to let them know that they made a mistake. | ||||||
Discipline: |
We both believe respect discipline. We would both have the same rules and we would both be dominant. Positive behavior is encouraged with positive consequences, like treats in r belly rubs. Negative behavior has negative consequences. | ||||||
Where would Pembroke spend the majority of the time: |
We anyone was home they would spend the time either inside with us or outside in the yard. When no one is home, until trained, they would be in a crate. There is only small amount of time during the day were no one is home. | ||||||
Discipline: |
We both believe respect discipline. We would both have the same rules and we would both be dominant. Positive behavior is encouraged with positive consequences, like treats in r belly rubs. Negative behavior has negative consequences. Where would Pembroke spend the majority of the time: We anyone was home they would spend the time either inside with us or outside in the yard. When no one is home, until trained, they would be in a crate. There is only small amount of time during the day were no one is home. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. One of us doesnt work until 1pm and the other is home at 5pm. | ||||||
Where would dog eat? |
In the kitchen or living room. Depending on the dogs personality and attitude towards meal time. | ||||||
Where would dog sleep: |
Until trained in the crate with a bed. After he will have two beds one in the crate and one in our room. | ||||||
Play & exercise: |
Kendall goes for runs/walks every morning. Christian would like teach them games that he use to play with his old corgi. We both like keeping busy. | ||||||
How will you exercise your dog? |
On leash | ||||||
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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? |
3 of the four side of the fence are wooded privacy fence. The fourth side is a chained fence. We are looking into completing the fence in the next month. | ||||||
Living arrangements: |
Rent/lease home | ||||||
Landlord info: |
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May we contact your landlord? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
The backyard has a small porch that is wooded. The Fence is 3/4 privacy were we are looking to get the remaining chained fence completed to a privacy fence. There is a small shed. | ||||||
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? |
Kendall and Christian (we are a team) | ||||||
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? |
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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