| Date & Referral Source | |||||||
| State: | Date of Application: | 01/02/2019 | Referred by: | Friend | |||
| 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 | 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? |
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? |
Laura Conger (Applicant 1) | ||||||
Why do you want a Pembroke? |
I grew up with dogs and am definitely a dog person who is looking for a furry companion to share my life with. I prefer medium/large dogs because their temperment is usually more compatible with my personality. However, I don't have the space for a very large dog and am not physically big enough to deal with wrangling a big dog by myself. I really like corgis because they have a large dog personality inside of a smaller body and the look of Pembrokes is so sweet! All the Pembrokes I have met before are sweet, playful, and outgoing – something that I truly appreciate about dogs in general. | ||||||
Activities planned with Pembroke: |
I would really enjoy taking my Pembroke on walks, to play in the dog park, hang out with friends (human or dog), and if he/she is up for it take them onboard my kayak to ride around and/or play in the lake near my apartment. I would also be happy to snuggle up to my Pembroke in the evenings or simply hang out a relax together. | ||||||
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: |
If it is early on in our relationship, I would gently but firmly show him/her the correct action until he/she understands what I am looking for. If this is a longer term problem, I would make firmly let him/her know that the bad behavior is not acceptable and also try different positive training methods to encourage the right behavior. | ||||||
Discipline: |
Vocal displeasure and hand signals are a good place to start if this is the first time an issue appears; withholding positive attention if the behavior is recurring but not immediately harmful to the dog/humans; repetitive deterring of bad behavior using things like non-toxic scents, removing items that instigate the bad behavior from the dog's territory, and minimal physical restraint if necessary. | ||||||
Where would Pembroke spend the majority of the time: |
In my apartment or a local doggie daycare (when I am not at home) and the surrounding areas (when we are together) | ||||||
Discipline: |
Vocal displeasure and hand signals are a good place to start if this is the first time an issue appears; withholding positive attention if the behavior is recurring but not immediately harmful to the dog/humans; repetitive deterring of bad behavior using things like non-toxic scents, removing items that instigate the bad behavior from the dog's territory, and minimal physical restraint if necessary. Where would Pembroke spend the majority of the time: In my apartment or a local doggie daycare (when I am not at home) and the surrounding areas (when we are together) |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Not normally, but I have access to a doggie daycare facility if needed and I can easily come back home if something happens. | ||||||
Where would dog eat? |
In my apartment, probably in the kitchen or another location that is easy to clean. Water bowl would be placed somewhere comfortable for the dog to get to at any time and food bowl either be open for grazing or filled on a schedule (depending on what works best with the dog) | ||||||
Where would dog sleep: |
In a dog bed in my bedroom or other location the dog prefers, on my bed if the dog likes that, or in a crate if that makes the dog comfortable. However, I would prefer my dog sleep near me if he/she wants to. | ||||||
Play & exercise: |
I am willing to walk my dog in the evening and/or take him/her out to play at the dog park or in a local park that is dog friendly. On weekends I am willing to take my dog on longer adventures outside as he/she prefers. | ||||||
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? |
Not applicable | ||||||
Breed/size restrictions? |
Yes | ||||||
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Description of yard: |
not applicable | ||||||
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? |
Laura Conger | ||||||
Willing to train children? |
Although there are no children in my home, I am willing to take the time to teach children who are likely to come in contact with my dog how to humanely care for animals and the appropriate way to approach an animal. | ||||||
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Any allergies? |
One or more family members might be allergic to dogs. | ||||||
Current pets: |
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Current pets dog friendly? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
Yes, of course! | ||||||
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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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