| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 04/04/2019 | Referred by: | Other | ||
| Contact Information | |||||||
| First name: | {First Name:98} | Last name: | {Last Name:97} | First name 2: | {First Name 2:94} | Last name 2: | {Last Name 2:93} |
| Address | |||||||
| Street: | {Street Address:3} | ||||||
| City: | {City:4} | State: | {State:5} | Zip: | {Zip:6} | ||
| Type of Dog Wanted | |||||||
Ages interested in: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
Must be okay with other pets when I visit home! | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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} | ||||||
| Questions Regarding Motivation for Adopting and Intentions | |||||||
|
Who is this dog for? |
This corgi will be my companion in graduate school. I am a senior graduating from Purdue University, and I will be moving to St. Louis in August to start graduate school. I grew up on a farm with corgis, so I am looking forward to having my own companion at school with me. | ||||||
Why do you want a Pembroke? |
Growing up and currently, we have two pembroke corgis. They have brought so much joy into my life! They are playful enough to play outside with us and hangout, but also snuggle up and chill at the end of a long hard day. I love that each individual dog has such a unique and loyal personality- they truly become family members. I have had nothing but positive experiences with the breed and I am looking forward to having my own. I have done research on the breed and having corgis we know we need to keep an eye on their weight to avoid added stress to their joints! | ||||||
Activities planned with Pembroke: |
Moving to St. Louis there are many dog park and there is Forest Park in my neighborhood. Forest Park is a 1,000 acre park in the middle of the city. I enjoy staying outside and being active so I look forward to exercising my corgi on a regular basis and playing with them in the park. Our corgis will play all day but also will sit at our feet when we are watching a movie or doing work – and I plan on doing these same things with mine! | ||||||
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? No |
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|
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: |
When we were training our corgis, they were fast learners and quickly learned the word “no”. Once they learned it, we would use a stern “no” to steer them away from chewing things they weren’t supposed to. For potty training, we used a crate in the beginning and would always take them out right when they woke up and after they ate. We never used any physical discipline and if they did a good thing, they were rewarded. | ||||||
Discipline: |
Again, we taught them the word “no”. If they didn’t listen to that then calling their name sternly usually got their attention. For example, if they had gotten into the trash we would scold them with a “no” and their name and then make them lay down and stay for 5-10 mins. Again, we never used physical discipline on them because they are our family members. | ||||||
Where would Pembroke spend the majority of the time: |
They would spend most of their time in my apartment with me and outside for exercise. Our student lounge at the grad school allows pets so I would bring them with me to study and hangout. They will be with me as much as possible. | ||||||
Discipline: |
Again, we taught them the word “no”. If they didn’t listen to that then calling their name sternly usually got their attention. For example, if they had gotten into the trash we would scold them with a “no” and their name and then make them lay down and stay for 5-10 mins. Again, we never used physical discipline on them because they are our family members. Where would Pembroke spend the majority of the time: They would spend most of their time in my apartment with me and outside for exercise. Our student lounge at the grad school allows pets so I would bring them with me to study and hangout. They will be with me as much as possible. |
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|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I will have roommates and they have all owned and cared for dogs before. While at home, my dad is always home. | ||||||
Where would dog eat? |
At home, each corgi has their own little hutch for eating and relaxing – their own little space. I plan to create a similar environment for my corgi. | ||||||
Where would dog sleep: |
My corgi would sleep in my bedroom with me in their own bed on the ground next to my bed. Corgis have such little legs and long backs it is dangerous to have them sleep in the bed with you in case they want to jump down (they may hurt themselves!!). | ||||||
Play & exercise: |
I plan on taking them to dog parks and on walks in Forest Park as I mentioned earlier. Outside exercise will be about 45mins to an hour everyday, but will get an additional hour to hour and a half of play inside. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
|
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? |
|||||||
Living arrangements: |
I will live at home for 3 months out of the year and I will live in an apartment for the rest of the year. | ||||||
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? |
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Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
|
Description of yard: |
Living on a farm at home, we have a big back yard for our corgis to run and play. There are mostly trees and barns in the yard. No other fixtures. | ||||||
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? |
Me, Hannah | ||||||
Willing to train children? |
Yes | ||||||
|
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 | ||||||
|
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} | ||||||