| Date & Referral Source | |||||||
| State: | Date of Application: | 09/23/2018 | 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, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, 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? |
Our family of six plus an 11 year old yellow lab. Our children are 20, 18, 16, & 7. | ||||||
Why do you want a Pembroke? |
They are a smaller breed which is a good fit for our household because we have a big lab already. They appear to be playful, helpful, and fun loving which is the type of dog we are looking for. We have lived corgis for years because they are so cute, with their heart shaped bums that wag when they see you. | ||||||
Activities planned with Pembroke: |
We would love to take our Corgi on adventures to the Dog park, the dog beach, trips to grandma's house, walks around the neighborhood and playtime every day in the backyard with the kids. | ||||||
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: |
You talk to them and show them what has occurred. Patience and love. | ||||||
Discipline: |
We remove from the situation, discuss in a firm tone that those things are not appropriate, and give love. | ||||||
Where would Pembroke spend the majority of the time: |
I'm not sure how to answer your question. At our home | ||||||
Discipline: |
We remove from the situation, discuss in a firm tone that those things are not appropriate, and give love. Where would Pembroke spend the majority of the time: I'm not sure how to answer your question. At our home |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Sometimes, it truly depends on the day. | ||||||
Where would dog eat? |
In the kitchen | ||||||
Where would dog sleep: |
On his bed in our room or with one of the kids | ||||||
Play & exercise: |
Every day he would be given the chance to play outside we love to be outdoors. Our lab is getting older and doesn't like to play anymore. Our 7 year old daughter wants nothing more than to have a dog to play with. | ||||||
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? |
We have a two gate 6ft privacy fence. | ||||||
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 large privacy fenced yard. No pools, no play equipment, just nature. | ||||||
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? |
Sarrah | ||||||
Willing to train children? |
Our children are very respectful of all living things. | ||||||
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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 of course. We want our new family member to feel safe and welcome. | ||||||
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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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