Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 09/17/2019 | 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, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Energetic |
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? |
Our future family member is for my husband and I, and our two young teenage daughters. | ||||||
Why do you want a Pembroke? |
After our dog Tonka died 3 years ago I began looking into some of my favorite breeds in more detail for our future pup. I love the Corgi especially because of their wonderful disposition, intelligence and overall fun energetic personalities! I crave a pup who will interact with us and love to go where we go for adventures….walks, trips, camping, frisbee….that kind of thing. The Corgi is calling me! <3 | ||||||
Activities planned with Pembroke: |
Lots of outdoor time and adventures near and far! I take many walks along the Fox River and all around downtown St Charles. Le Roy Oaks Park is one of my favorites places to be and currently I have no Corgi (or any dog) to share it with. Also, my 2 teenage daughters would love to work with our new pup to do small dog courses in our fenced in back yard, frisbee and ball fun too of course! | ||||||
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: |
Firmly look him in the eye with a stern but not yelling "no.", take his toys and treats out of reach for a short time and avoid physical praise of course right after. NEVER hit or physically punish. ever. | ||||||
Discipline: |
First of all, to help avoid having to discipline as often…..from the very beginning praise with affection, healthy treats and toys when he does a "good job". As stated in the first question I would with my "words" and not my "hands" sternly say "no" when he has had an accident or needed some discipline. Also, take treats and/or toys away temporarily. | ||||||
Where would Pembroke spend the majority of the time: |
With me 🙂 Inside our home when I am inside and outside when I am outside. I work in my fenced in backyard edible garden a lot and so he would be with me. <3 | ||||||
Discipline: |
First of all, to help avoid having to discipline as often…..from the very beginning praise with affection, healthy treats and toys when he does a "good job". As stated in the first question I would with my "words" and not my "hands" sternly say "no" when he has had an accident or needed some discipline. Also, take treats and/or toys away temporarily. Where would Pembroke spend the majority of the time: With me 🙂 Inside our home when I am inside and outside when I am outside. I work in my fenced in backyard edible garden a lot and so he would be with me. <3 |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I am a stay home mother of two teenage daughters and full time homemaker. And hopefully a Corgi. 🙂 | ||||||
Where would dog eat? |
Since our 2 cats and one dog have all passed in the last 3 years. Our last elderly cat just passed a little over a month ago, and I will put his food and water in the empty pet spot in our kitchen were our kitties food area was. | ||||||
Where would dog sleep: |
Our cat had two sleeping spots and so I will use those two spots for our Corgi too. There is a covered area that I made in the living room with an open bed right outside the "door" of the pet house. Also, a pet bed in the kitchen for him too as I spend a lot of time cooking. | ||||||
Play & exercise: |
As stated before, I take a lot of walks along the river and at the many, many St Charles Parks that are close to my house. We would drive to the parks to explore often, walk downtown and in the neighborhood. Also, my fenced in back yard is a place to throw balls, frisbees and work on our little dog-course. 🙂 | ||||||
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? |
It is a tall wooden fence that is totally enclosed with a gate that locks. It is an "L" shaped backyard since we live on the corner and have more backyard room. | ||||||
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: |
Fairly large "L" shaped backyard with a wooden painted deck with table and 4 chairs, one swing hung from a large tree, picnic table in shade, an above ground hot tub that is always covered and locked when someone is not in it. No swimming pool. Volleyball net set up in summer. Plenty of room in the middle of the yard for our Corgi sport course! | ||||||
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? |
Me, JoAnne Johnson (Mom and wife) | ||||||
Willing to train children? |
Yes, our family has always had pets in the house until very recently. They know, are willing and will be loving and responsible to any and all animals. | ||||||
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? |
N/A | ||||||
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} |