| Date & Referral Source | |||||||
| State: | Date of Application: | 12/15/2018 | Referred by: | Other | |||
| 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
Friendly with other dogs. Relaxed in public. |
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| Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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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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? |
For us, a newlywed couple! | ||||||
Why do you want a Pembroke? |
We absolutely love the breed for their personalities, their intelligence, and their love for their families. We feel like their energy level would be a good fit for our home because we like to go out and about to outdoor restaurants and parks. We love how intelligent they are and feel like their food motivation can very much help with training purposes. We have neighbors with corgis and that has been most of our contact with them. We also have done much research and will continue to do so as we move forward with adoption and have experiences with our corgi. | ||||||
Activities planned with Pembroke: |
Walks, go to parks, go to outdoor restaurants, go to dog parks, hike, visit friends with dogs, lounge, cuddle, and play with toys. | ||||||
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: |
Try to understand what circumstances led to the mistake and try to intervene with positive reinforcement before the mistake is made again. | ||||||
Discipline: |
Use an authoritative voice to help the corgi discern good and bad behavior. We would never use the crate for discipline purposes. | ||||||
Where would Pembroke spend the majority of the time: |
In our home. | ||||||
Discipline: |
Use an authoritative voice to help the corgi discern good and bad behavior. We would never use the crate for discipline purposes. Where would Pembroke spend the majority of the time: In our home. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Sometimes. Jason has the ability to work from home some days. Other days, the corgi would be home alone around 8 hours or would go to doggy daycare. | ||||||
Where would dog eat? |
In/near the kitchen is a space for food bowls to go. | ||||||
Where would dog sleep: |
Crate | ||||||
Play & exercise: |
Our corgi will get multiple daily walks and playtime. Somedays we will go to the park, hike, or dog friendly facility. | ||||||
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: |
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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
N/A | ||||||
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? |
Kathleen and Jason | ||||||
Willing to train children? |
Yes. We do not have children currently, but if we do have them we absolutely would teach them how to treat animals appropriately. | ||||||
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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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