Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 07/26/2019 | 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 | Gender preferred: |
Male | Color preferred: |
Red & White, Red Headed Tri | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Other (Please describe in the box below.) |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
The pembroke is for myself. | ||||||
Why do you want a Pembroke? |
I love how corgis look like they are smiling when someone is petting them. I like their ability to comfort others by their cuddly personalities. I had a corgi mix until about 2 weeks ago when he got a blood infection and passed away. Since then, I have been doing a lot of research on the breed and determined that a full pembroke is the breed that is perfect for me and for what I am looking for. I am looking for companionship and something to take care of and since corgis and very loyal and enjoy the companionship too, we would make a good match. | ||||||
Activities planned with Pembroke: |
I am a triathlete who loves to go on long walks but i don't like to walk by myself so I would walk the corgi by the marina and the local parks. I would also take the dog to the lake during the summer seasons and sit at collectivo by the lake and watch all of the cyclists go by. I would also spend my nights relaxing with my corgi with some inside toys and television. |
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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: |
Calmly, but make sure the i provide proper correction. | ||||||
Discipline: |
Proper corrections negative punishment but most importantly, positive reinforcement so the dog knows what they are doing right and its important to reinforce the good behavior they are showing. |
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Where would Pembroke spend the majority of the time: |
With me in my apartment, but of course we would walk regularly and go and do things together. | ||||||
Discipline: |
Proper corrections negative punishment but most importantly, positive reinforcement so the dog knows what they are doing right and its important to reinforce the good behavior they are showing. Where would Pembroke spend the majority of the time: With me in my apartment, but of course we would walk regularly and go and do things together. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, between my roommate and I someone is home with the exception of an hour when out schedules overlap. | ||||||
Where would dog eat? |
At my apartment, from a designated dog bowl that I would put in the entry way. | ||||||
Where would dog sleep: |
In a dog bed. I would place a dog bed in my room and the living room and leave my door cracked open so my corgi could choose where it would like to sleep. | ||||||
Play & exercise: |
I am a triathlete so i am very active. I have the time to take the corgi on morning and evening walks with my work schedule and i will provide it with plenty of toys for independent play inside the apartment. I often go to my parents home which has a 2 acre (partially fenced in) yard that my corgi could run and play in and get extra attention and love from my family. | ||||||
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: |
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? |
Yes, you may 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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
N/A | ||||||
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? |
Natalia Smart | ||||||
Willing to train children? |
I do not have children, but if children do come into the picture later on for me I would without a doubt take the time to teach my child how to care and nurture the corgi. | ||||||
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. | ||||||
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} |