Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 08/27/2019 | 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: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
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? |
Myself | ||||||
Why do you want a Pembroke? |
I love corgis!! I think corgis are really great breeds because they are smart, willing to be adventurous and have special personalities (even the sassy guys!). Aesthetically, I think they are so cuddly and stumpy, and I just love them! I am a small person, so a small dog is a right choice for me. I have done a lot of research on the breed because I know they can be strong-willed and I want to know how to best take care of them in the way they need to. | ||||||
Activities planned with Pembroke: |
I like walking and hiking, so walks would be a daily activity for us. I have a few dog parks in my area, so playing fetch and socializing with other dogs is something that I think is important for a dog, as well. In addition, I live close to a doggy daycare, so I will most likely taking him/her while I am at work a few times a month. I know corgis are pretty social, so I want that to be a big part of his/her life. I also like going to dog-friendly events, so that is something that I would like to do if he/she is comfortable with groups of people. If not, I don't mind tailoring my social activities. | ||||||
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: |
It depends what the mistake is! I know with corgis you have to be calm and assertive and you need to have their respect. I have used a clicker before to refocus behavior and I have used diversion/ ignoring if he/she is doing something I would like them not to do! I never believe in yelling/hitting. It's not healthy for anyone to be treated like that! | ||||||
Discipline: |
Positive reinforcement is something that I think works best for behaviors, however, when they do something naughty, I plan on doing redirection. If there is a behavior I do not know how to handle, I have no insecurities about asking my vet or an expert! | ||||||
Where would Pembroke spend the majority of the time: |
Mostly at home or in the surrounding area! Most of the time, he/she will be at my apartment and on our grounds, but I would like to enroll them in doggy daycare a few days a month while I am at work. | ||||||
Discipline: |
Positive reinforcement is something that I think works best for behaviors, however, when they do something naughty, I plan on doing redirection. If there is a behavior I do not know how to handle, I have no insecurities about asking my vet or an expert! Where would Pembroke spend the majority of the time: Mostly at home or in the surrounding area! Most of the time, he/she will be at my apartment and on our grounds, but I would like to enroll them in doggy daycare a few days a month while I am at work. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I have 2 roomates and we have varying schedules. I think the longest he/she would be home alone is 6 hours. | ||||||
Where would dog eat? |
There is a spot that I am able to put bowls in my kitchen. | ||||||
Where would dog sleep: |
most likely in my room. | ||||||
Play & exercise: |
As mentioned, walking, dog parks, frequent socialization is my goal! I plan on doing 2-3 walks daily plus some indoor play. | ||||||
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? |
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? |
Yes | ||||||
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? |
Myself, Jamie Christensen | ||||||
Willing to train children? |
Yes, however I do not have children in my household at this time | ||||||
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! | ||||||
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} |