| Date & Referral Source | |||||||
| State: | Date of Application: | 12/12/2018 | Referred by: | Website, Breeder | |||
| 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) | Gender preferred: |
Either a Male or a Female | Color preferred: |
Red & White, Sable & White, Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
My daughter was recently diagnosed with anxiety and depression, her hamster recently passed and she's in a fairly new school. She has wanted a Corgi for years. After researching several breeds including Pembroke and Cardigan Corgi's she felt strongly the Pembroke temperment matched hers. We have other pets and that's my reason for wanting as young a dog as possible for that early socialization. We have cats(2 rescued), as well as 1 of each: bunny, bird, bearded dragon. There's alot of love in our home and we'd like to share that with my daughters favorite breed, a Pembroke Welsh Corgi. This is the only thing on her Christmas wishlist. | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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| Dog 2 | |||||||
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| Dog 3 | |||||||
Dog 3 name: |
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| Dog 4 | |||||||
Dog 4 name: |
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| Questions Regarding Motivation for Adopting and Intentions | |||||||
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Who is this dog for? |
My youngest daughter in particular, but for the whole family as well. | ||||||
Why do you want a Pembroke? |
I touched on this in the previous section. This puppy would be for my daughter who was recently diagnosed with anxiety and depression. School hasn't been kind to her in the past. Also get hamster recently passed. She has loved the PC breed for years and we have researched it and taken all kinds of dog breed tests to confirm what she already knew, this is her dog breed. Not far from our home, in Evanston Il there is a population of PC's we see being walked often. That's where most of our interaction is primarily from. | ||||||
Activities planned with Pembroke: |
My daughter isn't the most athletic, by choice. However she loves going on walks, drawing, taking pictures in nature, and watching YouTube. Her Corgi would be her best friend, literally. Her 4 legged shadow. I think she'd tap into her athletic side more intentionally with the aid of her Corgi. On top of that, she's drown it in affection. | ||||||
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: |
Positive reinforcement. | ||||||
Discipline: |
Positive reinforcement, aka treats and head rubs. | ||||||
Where would Pembroke spend the majority of the time: |
Wherever my daughter was, her room, the family room, the living room. | ||||||
Discipline: |
Positive reinforcement, aka treats and head rubs. Where would Pembroke spend the majority of the time: Wherever my daughter was, her room, the family room, the living room. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes | ||||||
Where would dog eat? |
Kitchen | ||||||
Where would dog sleep: |
My daughter's room | ||||||
Play & exercise: |
Daily, backyard, neighborhood, with my daughter. | ||||||
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? |
Typical suburban chain link 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: |
Small water fountain, patio, grass area, completely fenced, large size. | ||||||
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? |
Myself, Amanda Richardson and my daughter Lexxy. | ||||||
Willing to train children? |
My children have been around animals their entire lives. They practice being humane with humans and animals in everything they do. | ||||||
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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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