| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 04/29/2019 | Referred by: | Website | ||
| 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: |
1 year – 3 years, 3 years – 5 years, 5 years – 10 years, 10 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 |
|||||||
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? |
Sadie Bennett (Me) as a companion | ||||||
Why do you want a Pembroke? |
I grew up taking care of larger dogs, including german shepherds, labradors, and bernese mountain dogs, however, these breeds would not work in an apartment, especially as my current apartment has a size limit for dogs. I am used to the personality of a large dog. Through research and interacting with corgis, they seem to embody that large dog spirit, in a smaller body. My sister owns a corgi mix, who I adore and love to play with. She is a sassy dog, who loves to play for hours, whine about her food and anything else she thinks inconveniences her, and then turn into an absolute couch potato. I would love to own a dog who is even remotely similar to that. | ||||||
Activities planned with Pembroke: |
Walks, playing in the yard, relaxing on the couch. I am fairly open for any level of activity. | ||||||
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 |
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|
Do you have a veterinarian? |
No | ||||||
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: |
If caught in the act, distract them from their activity, put them in a crate for a time-out, taking a toy and/or attention away from them. If the situation continued, I would try and figure out the root cause of the issue, and see if it can be fixed at the source. If its something like chewing, give them an alternative chew toy, or use something to make what they're chewing taste bad. I will also contact a trainer or vet as necessary, if I feel I am out of my depth in a situation. | ||||||
Discipline: |
Crate-training, if applicable to the dog, or taking away a favorite toy, or attention | ||||||
Where would Pembroke spend the majority of the time: |
In my apartment / their crate, depending on if they are crate-trained or need to be crate-trained. | ||||||
Discipline: |
Crate-training, if applicable to the dog, or taking away a favorite toy, or attention Where would Pembroke spend the majority of the time: In my apartment / their crate, depending on if they are crate-trained or need to be crate-trained. |
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|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No, but I would likely hire a dog-walker for any days I think I might be gone longer than usual | ||||||
Where would dog eat? |
In my kitchen | ||||||
Where would dog sleep: |
Probably in my bedroom | ||||||
Play & exercise: |
My building has a dog-run area which I would make use of for the dog to play and exercise in the mornings, afternoons, and evenings. The morning would probably be a 10-15 minute walk, the afternoon would be 30-45 minutes, with the evening being another 10-15 minute walk. These times would also vary, depending on the dog and their level of exercise needed. | ||||||
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? |
The fence is partially wooden and partially cast iron. | ||||||
Living arrangements: |
Rent/lease 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? |
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 | ||||||
|
Description of yard: |
There is a dog-run to the south of the building, which is a decent sized, fenced-in yard with grass. | ||||||
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? |
Sadie (me) | ||||||
Willing to train children? |
Yes (N/A) | ||||||
|
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} | ||||||