Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/21/2020 | 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: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
No disabilities | ||||||
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? |
Our family- 2 married adults and 3 children ages 15, 11, 9 | ||||||
Why do you want a Pembroke? |
My 11 year old daughter is obsessed with the cuteness and personality of the Corgi breed. I thought perhaps it would wear off, but 2 years later and she's still as enamored as the first time she saw them. She cries literally when she gets to play with them and the stickers of the Corgi align her notebook and waterbottle. Because of her joy, I've researched them and find them to be cuddly, cute dog friends, good for kids and family. They have long lifespans and just seem like a fun breed for our family dynamic. This would be my children's first dog, and I think a Corgi they could manage and be responsible to take care of him or her. | ||||||
Activities planned with Pembroke: |
We would walk our dog daily. My commitment as I am going through chemo for breast cancer, is that we would get a dog as a reward for me making it through treatment. Then, I need to get up and get moving. Having a dog will help my kids to stay active, and will get me moving as well. Particularly once Corona virus breaks, we will desperately need and appreciate the exercise and ability to move. | ||||||
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? |
No | ||||||
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: |
When we had a dog when I was a child, we would return him to the "scene of the crime" and talk to him to say "that's wrong." I'm not sure all the new age techniques, but I would want to have an expert share with us what strategies work to help teach the dog to follow 'the rules', without any abuse or harm coming to the dog. Dogs make mistakes. It happens. | ||||||
Discipline: |
Some alone time, removing them from the scene, removing toys, not sure what else. No corporal punishment, not chaining the dog to a post. I don't believe in cruelty, but teaching the right behavior. | ||||||
Where would Pembroke spend the majority of the time: |
In the house, they would have their own space, maybe in our finished basement, but likely in the front living room of our house, or with my children. | ||||||
Discipline: |
Some alone time, removing them from the scene, removing toys, not sure what else. No corporal punishment, not chaining the dog to a post. I don't believe in cruelty, but teaching the right behavior. Where would Pembroke spend the majority of the time: In the house, they would have their own space, maybe in our finished basement, but likely in the front living room of our house, or with my children. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
My husband and I are both self employed and usually at home through the day while kids are at school. | ||||||
Where would dog eat? |
In the kitchen, not sure. Open to suggestions. We also have a finished basement and laundry area. | ||||||
Where would dog sleep: |
Not sure, with my kids, or in their own "bed" near the kitchen. | ||||||
Play & exercise: |
3 kids- daily walks, doggie parks and even "classes" if we can find appropriate ones. | ||||||
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? |
Small city lot, completely enclosed when the gates are closed. | ||||||
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: |
Small plot of open grassy land, no pool, no garden, just grass. Fenced in, alley in the back, but there's a fence to get to it. | ||||||
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? |
Leah Harris | ||||||
Willing to train children? |
Absolutely. We have had fish, hamsters. Our kids are all eager and interested in getting a dog and being responsible for it. They are all especially compassionate around animals as are my husband and I. | ||||||
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? |
We have no pets currently. | ||||||
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} |