| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 05/14/2019 | Referred by: | Breeder | ||
| 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: |
Male, Female, Either a Male or a Female | Color preferred: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Other (Please describe in the box below.) |
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? |
Myself | ||||||
Why do you want a Pembroke? |
I grew up with two dogs, so now that I am living on my own, I would like to have the companionship of owning another one. Some things that I love about Corgis are the way they look, their intelligence, and their loyalty. Over the past two years, I have done a bunch of research on the breed and spoken to two breeders. I have also looked into different ways of training the dog and how training a corgi can vary from other breeds. Even though I have talked to breeders, I would prefer to rescue so that I can give one a forever home. | ||||||
Activities planned with Pembroke: |
I would love to walk around town with my corgi, try and play fetch, go for hikes, and even see if I can teach it a trick or two. | ||||||
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: |
From the research that I have done, I would use positive reinforcement. To do so, I would reward the behavior that I want to see with treats or food (but also be careful to not overfeed the dog). | ||||||
Discipline: |
If they're ripping at fabric or something they shouldn't be, I would pick them up and move them away until they learn that they are not supposed to do that. One thing I would not do is hit the dog, I don't believe that that would help in any way. Sometimes a time out might be in order for the dog to give them time to calm down if they're riled up. | ||||||
Where would Pembroke spend the majority of the time: |
During the work day, the Pembroke would stay in my apartment. There is plenty of floor space, however I think it would be good to make sure they are crate trained first, after that, they could stay in a fenced off area of my apartment. | ||||||
Discipline: |
If they're ripping at fabric or something they shouldn't be, I would pick them up and move them away until they learn that they are not supposed to do that. One thing I would not do is hit the dog, I don't believe that that would help in any way. Sometimes a time out might be in order for the dog to give them time to calm down if they're riled up. Where would Pembroke spend the majority of the time: During the work day, the Pembroke would stay in my apartment. There is plenty of floor space, however I think it would be good to make sure they are crate trained first, after that, they could stay in a fenced off area of my apartment. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No, however I live a 10 minute walk from work so I can easily stop at home on my lunch breaks. I also have the option to work from home as well. | ||||||
Where would dog eat? |
I would provide a food and water dish in the kitchen of my apartment on the ground. I would also like to keep the bag/container of food and anything else the corgi might try to eat off of the floor as I have read that corgis will not hold back on eating everything in sight. | ||||||
Where would dog sleep: |
If they are not crate trained immediately, I would first like to have them sleep in a crate until they learn that. After that, I have room in my bedroom for a dog bed where my corgi could sleep. | ||||||
Play & exercise: |
I would try to take them for a walk everyday. If I have to miss a day due to weather, time, or whatever, I would play with the corgi using toys in my home. | ||||||
How will you exercise your dog? |
On leash | ||||||
|
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: |
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? |
No, you may not 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: |
My apartment is on the first floor with access to a courtyard. The courtyard has a grill area that is surrounded by a large grass yard. | ||||||
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? |
Derek Johns | ||||||
Willing to train children? |
I do not plan on having children, but if I do have any, I would teach them how to care for 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, however I do not plan to have more than one pet in the future and I do not have any pets at the moment. | ||||||
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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} | ||||||