Untitled_2236

Applicant IL
State: {Applicant State:2} Date of Application: 02/13/2019 Referred by: Website
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

Ages interested in:
 0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years
Gender preferred:
 Female
Color preferred:
 Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color
Activity level:
 Couch Potato, Outgoing, Quiet, Playful

Other preferences:
 Must be cat friendly

Previous dog owner?
 Yes
 
Dog 1
 
Dog 1 name:
 {Dog Name (Most recent/ current first):24}
 
Dog description:
 {Description of Dog:25}
 
How long owned?
 {Length of time owned:26}
 
Where is this dog now?
 {Where is this dog now? (Explain if you no longer have the dog):37}
  Dog 2
 
Dog 2 name:
 {Dog Name (Most recent/ current first):30}
 
Dog description:
 {Description of Dog:33}
 
How long owned?
 {Length of time owned:35}
 
Where is the dog now?
 {Where is this dog now? (Explain if you no longer have the dog):39}
  Dog 3
 
Dog 3 name:
 {Dog Name (Most recent/ current first):29}
 
Dog description:
 {Description of Dog:32}
 
How long owned?
 {Length of time owned:36}
 
Where is dog now?
 {Where is this dog now? (Explain if you no longer have the dog):27}
  Dog 4
 
Dog 4 name:
 {Dog Name (Most recent/ current first):28}
 
Dog description:
 {Description of Dog:31}
 
How long owned?
 {Length of time owned:34}
Where is this dog now? {Where is this dog now? (Explain if you no longer have the dog):38}

Who is this dog for?

 Myself.

Why do you want a Pembroke?
 I love the breed! Our family has always had PWCs. My corgi girl, Zoey, crossed the rainbow bridge, at 13 years old one year ago at Christmastime. I am ready to adopt another corgi.

Activities planned with Pembroke:
 Walks, visiting friends and family, play date with other dogs, traveling, cuddlefests, etc.

Aware that Pembrokes are busy, noisy dogs?
 Yes

Money for basic care?

 Yes

Money for unforeseen medical expenses?
 Yes

Willing to house train?
 Yes
Willing to do formal training? Yes

Do you have a veterinarian?

 Yes

Vet contact info:
 {If yes, please provide contact information including the vet’s name, clinic name, street address, city, state, zip, and phone. Also include the website if there is one.:52}

Will handle mistakes Pembroke makes like this: 		I use positive reinforcement to redirect the dog away from the undesired behavior.

Discipline:
 Positive reinforcement.

Where would Pembroke spend the majority of the time:
 In the house with my cat and myself. I work part-time around the corner from my house and would be able to check on the pup frequently. Also, I would work with the pup towards the goal of going to work with me as I care for Alzheimer and Parkinson patients. My animal companions have provided many benefits such as companionship, calmness, happiness, etc. to people in my care.

Discipline:
 Positive reinforcement.
Where would Pembroke spend the majority of the time: In the house with my cat and myself. I work part-time around the corner from my house and would be able to check on the pup frequently. Also, I would work with the pup towards the goal of going to work with me as I care for Alzheimer and Parkinson patients. My animal companions have provided many benefits such as companionship, calmness, happiness, etc. to people in my care.

House dog or outside dog?

 House dog

People at home during the day?
 Yes. my son and I work staggered shifts so if the dog and cat were left alone it would be for very short stretches of time as I work just around the corner.

Where would dog eat?
 The Corgi would eat in the kitchen where her food station would be located.

Where would dog sleep:
 The corgi would sleep with me in my bed.

Play & exercise:
 I am active and I enjoy walking and exercise and I would take my Corgi with me.

How will you exercise your dog?
 Both on leash and restrained to the yard

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?
 I have a wooden 6ft, fence around my back yard.

Living arrangements:
 Own home

Landlord info:
 {If you rent/lease your home, please list the name, telephone number and email address of your landlord. State “Not Applicable” if you own your own home.:67}

May we contact your landlord?

Lease allow dogs:

Landlord permission:

Restrictive covenants?
 Not applicable

Breed/size restrictions?
 No

Description of yard:

 I have a small lot in the village that has a 6ft wooden fence on my property. I am replacing part of the fence with a chain link fence.

Household members:
 {Describe all the people who live in your home, include names, ages and interests. For example, Mary Smith, 29, Enjoys cooking, dog training, gardening and running.:75}

Everyone in household agrees about adopting a corgi?
 Yes, everyone agrees and wants to adopt a Pembroke Welsh Corgi.

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?
 Denise Cline (Me)

Willing to train children?
 My son is grown and I would never allow a visiting child to mistreat my animals.

Any allergies?

 No one is allergic.

Current pets:

{Please list and describe all of the pets that currently live in your home, including the name, type, age, sex and whether it is neutered. For example, Lenny, komodo dragon, 3 years old, not neutered.:80}

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 I am committed to working with both pets to make a harmonious home for them.

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.

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:
 {Personal References. Please list two people who know your family well, but who are not related to you (No moms, grandmas, sisters, etc) who will attest to the fact that you are a responsible, dedicated pet owner. Include the name of the person, their phone number(s), email and relationship you have with that person. For example, Mary Smith, 123-343-4444, 123-333-5767, marys@gmail.com, friend.:87}