Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 06/26/2019 | Referred by: | Friend | ||
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: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Quiet, Playful |
Other preferences: |
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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? |
It will be a family dog, however the dog will be for our 12 year old daughter. My husband is a stay at home dad and we are fully prepared to help her with the new dog. She actually takes very good care of our other furr-baby. | ||||||
Why do you want a Pembroke? |
My daughter is in love with them! Yes, we've all done the research…we owned a corgi mix as well (a corgi-basset hound who was insanely cute). The size is perfect, the fact that she can train the dog, it will cuddle with her and be "her" dog. Our existing dog was originally my dad's rescue. He passed away shortly after her rescue, so she came to our house and while she loves and considers our daughter her sheep, she prefers me or my hubs. | ||||||
Activities planned with Pembroke: |
Daily walks, lots of play in the backyard, our daughter wants a dog she can train and play with. She absolutely loves dogs, reads books about them, watches videos, does school reports…you get the picture. | ||||||
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? |
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: |
Well, my existing dog ate my anniversary filet mignon and all i did was yell at her and took it away. I mean, I yelled a lot. I even cursed at her. I might have asked her if she wanted to die…but that was all. Her punishment was not getting to finish the steak. | ||||||
Discipline: |
Dogs are like 3 year olds… you have to discipline in the moment. Lots of "no." Lots of redirection. If they piddle on the floor, you have to tell them no and show them outside (not as punishment or isolation). Dogs know when you are not happy with them. | ||||||
Where would Pembroke spend the majority of the time: |
Pretty much wherever they like in the house. The only place that is a no is my bed…but my kids bed is just fine with me. Yes, my animals get on the couch. Izzy has stolen my kid's poof in the living room (lol). | ||||||
Discipline: |
Dogs are like 3 year olds… you have to discipline in the moment. Lots of "no." Lots of redirection. If they piddle on the floor, you have to tell them no and show them outside (not as punishment or isolation). Dogs know when you are not happy with them. Where would Pembroke spend the majority of the time: Pretty much wherever they like in the house. The only place that is a no is my bed…but my kids bed is just fine with me. Yes, my animals get on the couch. Izzy has stolen my kid's poof in the living room (lol). |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. Someone is home at all times. | ||||||
Where would dog eat? |
In the family room, where the rest of us eat, including our other dog, Izzy.. (hubs is disabled, so we don't bother eating in the dining room much). | ||||||
Where would dog sleep: |
Pretty much where ever they like. Scout (our daughter) would love it if the dog slept with her (izzy doesn't do that – she prefers the hallway or the couch or the poof). | ||||||
Play & exercise: |
We have a good sized, privacy fenced yard, so lots of room to play. There is also a field across from the house. Izzy currently gets walks just about every single day, so one more on the walk would be fine. I'm pretty sure there would be training opportunities as Scout likes to watch all manner of dog videos, including agility. | ||||||
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? |
6 foot wood privacy fence. | ||||||
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: |
We have a 120×80 foot lot. The yard is completely privacy fenced. It is a fair sized yard. There is a 4 foot above ground pool, but that doesn't stop Izzy from running around like a fool when she is feeling playful. There is also a fenced off area for a garden and various large planters on the patio. | ||||||
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? |
It will be Scout | ||||||
Willing to train children? |
Yes, already have. She walks Izzy daily. Cleans up the waste in the yard, keeps her brushed, and it is her job to make sure Izzy has food and water (although both Mark and I also make sure this happens too). Scout also comes to vet visits. She is a very responsible kid and has worked hard to be a good pet mom.
To the allergy question, yep, allergic to dogs…hasn't stopped me from adopting the other 4 dogs I've had. They just don't sleep with me….ok, well, mostly they don't. lol It is fine. |
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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} | ||||||
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. We've had multiple dogs in the past, and even had them with cats. Introduce slowly and it will be fine. | ||||||
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} |