Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 10/15/2019 | 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, 10 years + | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
We do have another dog that would need to be introduced to any dog we consider adopting. I want to make sure they will get along before we bring another dog into our home. He is friendly and has gotten along well with most every dog he's met but I'd rather be safe and have a meeting beforehand. | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
|||||||
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? |
Steve and I love corgis and would love to adopt one who needs a good home. We have an adult male mixed-breed dog, Bojangles, (70 pounds) who gets along very well with other animals including the corgis he has met. We have a large yard and plenty of dog beds waiting for our new family member. Our new family member would be crate trained in our home and would likely come to work with me (Megan) several days a week if possible. | ||||||
Why do you want a Pembroke? |
Corgis are smart and challenging dogs. I have been enjoying the continuing process of training with BoJangles and am excited to work with an intelligent herding breed. I also think they are adorable, obviously but that isn't the main driver behind our desire to adopt. | ||||||
Activities planned with Pembroke: |
Regular walks, training activities to learn basic commands and if possible more complicated training, hiking and camping when possible, fetch, relaxing at home, etc. We bring our dogs with us everywhere we can (if appropriate). | ||||||
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: |
See answer for Discipline below | ||||||
Discipline: |
distraction & correction,, rewards for correcting bad behavior, grabbing the scruff of the neck to stop a bad behavior while loudly saying no, giving the dog an alternate activity (command or toy) to discourage the bad behavior – honestly it depends on the situation. Our current boy is very food driven so rewards with treats is how we work with him. However, this isn't a great option for corgis due to their size. | ||||||
Where would Pembroke spend the majority of the time: |
With me as much as possible, in our home, in our yard supervised, he or she will have a crate in one of our bedrooms for crate training with the goal of graduating to free reign within certain parts of our home (living room/kitchen). | ||||||
Discipline: |
distraction & correction,, rewards for correcting bad behavior, grabbing the scruff of the neck to stop a bad behavior while loudly saying no, giving the dog an alternate activity (command or toy) to discourage the bad behavior – honestly it depends on the situation. Our current boy is very food driven so rewards with treats is how we work with him. However, this isn't a great option for corgis due to their size. Where would Pembroke spend the majority of the time: With me as much as possible, in our home, in our yard supervised, he or she will have a crate in one of our bedrooms for crate training with the goal of graduating to free reign within certain parts of our home (living room/kitchen). |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No but I work within 30 minutes of home. If we are able to train our new friend well, he or she would come to my office with me and be an office dog. | ||||||
Where would dog eat? |
Bowl in the kitchen | ||||||
Where would dog sleep: |
Dog bed in our room or in a crate in the adjacent room | ||||||
Play & exercise: |
We will walk several times a day and play every evening. We have a dog walker that can make up for days where we aren't able to fit in enough walks. We hope that our corgi will get along with and play with our dog Bojangles. | ||||||
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? |
|||||||
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? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
Large grassy yard with a few large trees. Wetlands present behind the house behind large grass yard. Wooden deck over brick 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? |
Megan Conway | ||||||
Willing to train children? |
We don't have children but have discussed this extensively – any children we have in the future will be taught to respect animals and how to behave properly around them. This is very important to me! | ||||||
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} |