Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 07/03/2019 | Referred by: | Other | ||
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 | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
We prefer a male dog, but are not opposed to a female dog. I've only adopted male dogs in the past. | ||||||
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? |
Our family | ||||||
Why do you want a Pembroke? |
My 10 year old daughter and I have read a few library books on Corgis, but we have never met an adult Corgi. We did meet a puppy at a pet store and his personality was inquisitive, playful, and sweet. I'm not sure if that's the breed or just the puppy. | ||||||
Activities planned with Pembroke: |
I take my Beagle on walks, so of course, our Corgi would accompany us. We go camping with our Beagle and we have brought him along on a few road trips with a fancy hotel stay. Our Beagle is a great dog and we enjoy snuggling, grooming, training, and walking him. Depending on our Corgi's age and activity level, I would like to play catch with him like I used to do with my lab mix. | ||||||
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? 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: |
That depends if I see it happen or not. If I see it happen, I run the dog outside to let them finish and praise them for going where I want. I find that positive reward is the best way to train a dog. | ||||||
Discipline: |
I will use a low voice for letting my dog know if his behavior is not OK. Sometimes my Beagle chews, and I let him know it's not OK in a low voice. I clean it up and address the real issue…he missed us. He usually does this if we all leave the house after dinner for a few hours. | ||||||
Where would Pembroke spend the majority of the time: |
At first, in his crate. Once he can be trusted, he is free to use the house. Our pets are not allowed on furniture and if we don't want them in a room, we close the door. | ||||||
Discipline: |
I will use a low voice for letting my dog know if his behavior is not OK. Sometimes my Beagle chews, and I let him know it's not OK in a low voice. I clean it up and address the real issue…he missed us. He usually does this if we all leave the house after dinner for a few hours. Where would Pembroke spend the majority of the time: At first, in his crate. Once he can be trusted, he is free to use the house. Our pets are not allowed on furniture and if we don't want them in a room, we close the door. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Not very day. I teach at a university, and my schedule changes every semester. But, I work from home 2-3 days during the week and am home by 3p when kids get home from school | ||||||
Where would dog eat? |
We feed our Beagle Wellness Core. | ||||||
Where would dog sleep: |
Our Beagle sleeps next to our bed, but he has a bed in every bedroom. The Corgi would have thr same treatment once he is comfortable doing so. | ||||||
Play & exercise: |
We walk our dog every day 2 – 3 times and when he's in the mood, we play with him. If the corgi needs more exercise, we have a nice backyard that we can play in. | ||||||
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: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We have a backyard with a small swings and a zip line. We have a lot of mature trees and it is pretty shady. We do not have a lot of bushes. We live in an older section of town. | ||||||
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? |
Christy | ||||||
Willing to train children? |
Yep | ||||||
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? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
Yes, to a degree. Bolt is an amazing dog and wonderful companion. We certainly do not want him to be too stressed. | ||||||
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} |