| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 05/24/2019 | 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 | Gender preferred: |
Male | Color preferred: |
Red & White | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
We would love if our new four legged friend has pointed ears! But it is not a deal breaker. | ||||||
| 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? |
We would love to add a Pembroke to our family! | ||||||
Why do you want a Pembroke? |
I would like to adopt a Pembroke Welsh Corgi because I absolutely love their little legs and cute little butts! They are normally lively dogs and companionable which is perfect for our family, but if ours is a little less energetic that's okay too! I have had a few experiences with the breed through family friends and aquitances with Pembroke Welsh Corgis. I have done a lot of research and continue to do so as I want to make sure we can give our little corgi the best life possible. | ||||||
Activities planned with Pembroke: |
Daily walks, playing, training. We have plenty of area for our Pembroke to play and have time for himself as well. We love going on nature walks so we would love to have our Pembroke come along! | ||||||
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: |
Depending on the mistake we would act accordingly. A small mistake happens, we wouldn't encourage it to continue making that mistake but we wouldn't punish it either. | ||||||
Discipline: |
We plan on following a respect training program. Positive encouragement such as treats, positive language, and petting. However if they do something negative, a consequence has to be involved. Mostly involving tone of voice, body language and in extreme circumstances a hand. Never hitting but a tap so that they at least know how serious something is. | ||||||
Where would Pembroke spend the majority of the time: |
We have a large outdoor area outside to walk with our corgi. Hopefully we can train it to be off a leash so we can play with it outside. | ||||||
Discipline: |
We plan on following a respect training program. Positive encouragement such as treats, positive language, and petting. However if they do something negative, a consequence has to be involved. Mostly involving tone of voice, body language and in extreme circumstances a hand. Never hitting but a tap so that they at least know how serious something is. Where would Pembroke spend the majority of the time: We have a large outdoor area outside to walk with our corgi. Hopefully we can train it to be off a leash so we can play with it outside. |
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|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
We spend most of our time home. We all work but when we get home we spend time with our dogs. | ||||||
Where would dog eat? |
Most likely near our other dogs but during early training separately until our entire family including the corgi is comfortable with the idea. | ||||||
Where would dog sleep: |
With me and my partner in our room. Either on our bed or in their own bed. | ||||||
Play & exercise: |
We will spend time outside with them every day as long as the weather allows. Or we will spend time with them inside most likely catch or a rope toy. | ||||||
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? |
No | ||||||
|
Description of yard: |
Our yard does not have any major fixtures. Just open land and a 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? |
No, I will not 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? |
Devin Formell & Isabella Rivas | ||||||
Willing to train children? |
We currently do not have any children in our household but we would be more than willing to teach them how to humanely care for animals once we get to that point. | ||||||
|
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 of course! We will do everything we can to resolve the problem. | ||||||
|
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} | ||||||