| Date & Referral Source | |||||||
| State: | Date of Application: | 01/31/2019 | 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: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
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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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 | ||||||
Why do you want a Pembroke? |
Originally, my daughter asked to get one just because she thought they were so cute. We've watched countless videos of this spirited breed. We started to research the breed more extensively as the consideration to get one became more serious. Our 15 yo JRT is nearing her life expectancy and we could never replace her, but would like to maintain a companion for our 4 yo JRT after our senior girl is gone. | ||||||
Activities planned with Pembroke: |
My daughter has worked extensively with our current pups in training them, teaching them tricks and making sure they're well adjusted. My husband is a huge animal lover and our JRT's accompany him around to do 'chores' and we keep them quite busy. We're an active family and we live in a rural area with lots of room to roam. | ||||||
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: |
Gentle correction and positive reinforcement with corrected behavior. | ||||||
Discipline: |
Gentle correction and positive reinforcement with corrected behavior. Depending on the offense, a verbal scolding, but never any physical discipline. |
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Where would Pembroke spend the majority of the time: |
In the house, outside on the 7 acre property, visiting the in laws 40 acres just miles away from home. Car rides (if they like them) and pretty much anywhere we go as a family. | ||||||
Discipline: |
Gentle correction and positive reinforcement with corrected behavior. Depending on the offense, a verbal scolding, but never any physical discipline. Where would Pembroke spend the majority of the time: In the house, outside on the 7 acre property, visiting the in laws 40 acres just miles away from home. Car rides (if they like them) and pretty much anywhere we go as a family. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Constantly on the weekends, although Monday through Friday they are left on their own from 9-5. They have access to a doggy door that leads to a fully fenced in yard that is large enough to run and play. | ||||||
Where would dog eat? |
The food and water dishes are in the dining room near the kitchen. | ||||||
Where would dog sleep: |
Wherever they're comfortable. We have a serta posturepedic dog bed (2ft x 3ft) in our livingroom. They also have a smaller bed in the laundry room and another on the front porch. Our 4yo JRT usually sleeps with us. | ||||||
Play & exercise: |
We're an active family that is usually outside in any weather doing something. The kids play a lot of sports. We play a lot of fetch too! My daughter even made a small novice agility course for our JRT's | ||||||
How will you exercise your dog? |
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? |
Fully enclosed chain link fence that wraps around the entire front of the house and meets at the back. Has separate gates on 3 of the 4 sides. About 1/2 acre area. | ||||||
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: |
7 acres of wooded property. 3 acres are mowed. we have a 1/2 acre garden, 2 pole barns, another out building. 1/2 acre fenced in yard. Horseshoe driveway that wraps around the 2500 sq ft house which is on a hill. on the corner of 2 gravel roads that intersect. We can't see any other houses or neighbors from our place. Very rural. | ||||||
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? |
Larry and Maysse | ||||||
Willing to train children? |
They are all huge hearted animal lovers. Marley volunteers at the SPCA and would bring them all home if she could. Maysse is the one who initiated the idea of a corgi and Lindie is the sweetest most sensitive soul. They all respect people and animals and treat them as part of the family. They understand that they have feelings too and treat them as such. Very loving and affectionate. | ||||||
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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? |
Absolutely. We will work through the transition period until we're all acclimated. | ||||||
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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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