Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 01/22/2020 | 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 | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
We are a dog-saavy household that currently has two Saint Bernards; one with a rescue background, that are coming up on 11 years and one that just turned 4 years. We're hoping to add another member to our family to offer companionship to our younger boy as his 'sister' continues to age. They are both well socialized with other dogs, both big and small as well as altered and unaltered. However, our lady, Kylah, generally prefers males while our male, Hugo, does well with both but is more used to being around males. | ||||||
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? |
For us and our family, 2 Saint Bernards. | ||||||
Why do you want a Pembroke? |
I have always been a fan of the herding group and grew up with various breeds as both family and farm dogs; Australian Cattle Dogs, Border Collies, Australian Shepherds, German Shepherds, and various crosses. Corgi's have always been a favorite with their strong, stubborn, smart, loving, and independent personalities, compacted into a smaller body, we think they'd make a great addition to our family! We are familiar with the breed, their training and health needs and believe we can offer a great home to a rescue. | ||||||
Activities planned with Pembroke: |
We like to bring our dogs with us whenever we can whether that's to a brewery, a family member's house, a picnic or park, or a road trip, thus we like having social pets. However, we know that that's not always the case with a rescue and oftentimes, more time, confidence-building and a bond built over time are needed prior to such outings are necessary. | ||||||
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: |
Positive-reinforcement: encourage the behavior we would like, reward when it happens. | ||||||
Discipline: |
Positive-reinforcement: treat to encourage and reward correct/wanted behavior. | ||||||
Where would Pembroke spend the majority of the time: |
On our main levels with both of us and the other dogs, always supervised while outside in our fenced yard and strictly an indoor, family dog. | ||||||
Discipline: |
Positive-reinforcement: treat to encourage and reward correct/wanted behavior. Where would Pembroke spend the majority of the time: On our main levels with both of us and the other dogs, always supervised while outside in our fenced yard and strictly an indoor, family dog. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
It depends on the day of the week- I typically work long shifts (12 hours) thus have days off during the week but work every other weekend while David works 8a-4p Monday-Friday but has the flexibility of working from home when needed. On the days I work, including commute, the dogs are typically home alone for about 8 hours. | ||||||
Where would dog eat? |
We feed our dogs on our main, kitchen level. The Saints have raised, stainless-steel dishes over a mat; the corgi's dish would be either on a mat on the floor or raised slightly depending on size. | ||||||
Where would dog sleep: |
Likely in a crate until trustworthy with free-roam whether due to age, past circumstances, or comfortable with our current resident dogs. | ||||||
Play & exercise: |
We have a good-sized fenced yard as well as play with our current, resident dogs, playdates with family and friend's dogs, outings to public places such as breweries, picnics, etc, and walks. | ||||||
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? |
6 foot privacy fencing on all but a small section where it's 4 foot chain-link (where the gate is located). | ||||||
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: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
No swimming pools, fenced backyard that backs up to a wetland with surrounding parks and many walking trails. Deck off the main, kitchen level with ~ 5 steps down to the yard, walk-out basement onto a cement patio into the fenced backyard (bottom of deck stairs to the left when you walk out of the basement onto the 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? |
Kelsey and David | ||||||
Willing to train children? |
Absolutely! | ||||||
Any allergies? |
One or more family members might be allergic to dogs. | ||||||
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? |
Definitely; we know there's an adjustment period. We also trust that we know our dogs and what will or will not be a good fit. | ||||||
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} |