| Date & Referral Source | |||||||
| State: | Date of Application: | 10/22/2018 | 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, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, 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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Where is this dog now? |
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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 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? |
Both my husband and I. | ||||||
Why do you want a Pembroke? |
We want to adopt a Pembroke Welsh Corgi because we have done extensive research on the breed and feel that it would be a great fit as a sibling for our current dog. Our current dog is very mild mannered and gentle, and gets easily overwhelmed by large dogs with lots of energy. We have always loved the breed for their characteristics and believe it would be a great fit as far as energy level and mannerisms for our current dog. | ||||||
Activities planned with Pembroke: |
Honestly we focus the majority of our life around our dog, we take him pretty much everywhere we go that he is allowed to go too. We frequent the dog park, local woods for walking and lakes for swimming, doggie play groups, etc. But we are also always down to snuggle on the couch 🙂 | ||||||
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: |
We realize that dogs make mistakes, just like humans. If the Pembroke made a mistake we would address it ASAP, ideally while they are in the process so they know what they are being disciplined for, we would then firmly say no and/or snap (one of our preferred training methods) and redirect. | ||||||
Discipline: |
We primarily use positive reinforcement with our dog, but use “time outs” in his crate as necessary. He knows ‘no’ and ‘go home’ in terms of discipline which means go to his crate for a break. We have also trained him to respond to a snap if he is doing something he is not supposed to. | ||||||
Where would Pembroke spend the majority of the time: |
Our Pembroke would spend most of his or her time with us and Gotham either in our home or out in the community/in nature. | ||||||
Discipline: |
We primarily use positive reinforcement with our dog, but use “time outs” in his crate as necessary. He knows ‘no’ and ‘go home’ in terms of discipline which means go to his crate for a break. We have also trained him to respond to a snap if he is doing something he is not supposed to. Where would Pembroke spend the majority of the time: Our Pembroke would spend most of his or her time with us and Gotham either in our home or out in the community/in nature. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes | ||||||
Where would dog eat? |
Our adopted corgi would eat in the kitchen | ||||||
Where would dog sleep: |
Our adopted corgi would sleep in our bedroom | ||||||
Play & exercise: |
Our adopted corgi will have plenty of opportunities to play and exercise both in our fenced in yard, doggie play dates, walks/hikes and the dog park. They will get to play/exercise daily, as much as they are able/willing. | ||||||
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 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 completely fenced, grass yard. We do not have any fixtures such as swimming pools, however we do have a little doggy wading pool for Gotham. | ||||||
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? |
Kate & Nick will share the responsibility | ||||||
Willing to train children? |
We do not have children, but 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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