| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 05/03/2019 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years, 3 years – 5 years, 5 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: |
Good with people and other dogs. Not good with cats is generally okay. We don’t have any cats that live in our house. | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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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? |
Both of us! And a new brother or sister for our 9 year old dog, Harmony. | ||||||
Why do you want a Pembroke? |
I’m a certified dog trainer and started to fall in love with the breed after doing one-on-one training with a client’s Corgi. They are very intelligent dogs and learn quickly. That makes them a lot of fun and easy to train. I love both their looks and their characteristics. Being herding dogs they have natural behaviors that can be hard for some people, but I find them fun to work with and I like helping them use those natural behaviors to have fun while doing obedience training and just daily mental stimulation activities. They can be wonderful companion dogs, which is something we’re looking for. But I also understand that every Corgi is different and has their own unique personality. While some may be more people-oriented, other may not be. We’re looking for one who is a bit more people-oriented. | ||||||
Activities planned with Pembroke: |
Plenty of walks, hiking if the dog is physically able to do it (Our dog Harmony can’t do much more than 3-4 miles at a time), doing with us to dog parks, learning new tricks and fun mental stimulation exercises. We’re really just looking for a wonderful family companion. | ||||||
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? 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: |
There are many different ways to handle it. I generally use mild verbal corrections (like uhn-uhn) in conjunction with not giving them a reward for the behavior. Sometimes purposefully ignoring the behavior is appropriate as long as we praise the right behavior once it’s presented (think like in the case of begging). If you have questions about my training techniques or background please just ask. It’s easy to talk verbally about them, then write about them. | ||||||
Discipline: |
It’s a lot more re-directing to appropriate behaviors. But discipline does come into play if it’s something that I actively see happening (not something that happened in the past). An example would be: If my dad killed a rabbit. That’s not a behavior I want to reinforce, so I give a firm “no,” (our own body posturing sometimes comes into play here) make sure the rabbit gets taken away and then re-direct the dog to do something I want the dog to do (something he can be rewarded for). Any questions, please just ask. |
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Where would Pembroke spend the majority of the time: |
In the house | ||||||
Discipline: |
It’s a lot more re-directing to appropriate behaviors. But discipline does come into play if it’s something that I actively see happening (not something that happened in the past). An example would be: If my dad killed a rabbit. That’s not a behavior I want to reinforce, so I give a firm “no,” (our own body posturing sometimes comes into play here) make sure the rabbit gets taken away and then re-direct the dog to do something I want the dog to do (something he can be rewarded for). Any questions, please just ask. Where would Pembroke spend the majority of the time: In the house |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. My husband and I work opposite shifts. He’s first shift and I’m on 2nds and 3rds. | ||||||
Where would dog eat? |
In the kitchen. | ||||||
Where would dog sleep: |
Free-roam the house as potty training is solid. Otherwise, in a kennel until potty training. | ||||||
Play & exercise: |
Lots of play and exercise. It’s one reason I like the breed so much. They can be active and fun and a joy to work with in learning new things. | ||||||
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? |
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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? |
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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 | ||||||
|
Description of yard: |
3.5 acres with a pond, barn, garage, house, and fire pit. Some of the yard is “wild” grow (which my own dog loves to explore). We live next a county road that’s not widely used, but there are cars that come down it on occasion. We have neighbors about 1/4 mile down the road (closest ones). The back end of our yard buts up against a corn field. You can view this all on Google Maps. | ||||||
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? |
Alexandra | ||||||
Willing to train children? |
We don’t have children and our friends children rarely visit, but yes. | ||||||
|
Any allergies? |
One or more family members might be allergic to dogs. | ||||||
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} | ||||||
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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? |
Yes | ||||||
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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: |
{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} | ||||||