| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 04/03/2020 | 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: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
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| 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? |
Myself. | ||||||
Why do you want a Pembroke? |
I've always loved Corgis because of their stocky bodies and energetic, confident demeanor. While I don't have experience with Corgis specifically, I fostered an Australian Cattle Dog for a year so I'm well aware of everything that comes with herding dogs. | ||||||
Activities planned with Pembroke: |
When I fostered my Blue Heeler, I had a lot of success (and fun) with clicker training. So I will do all kinds of obedience training as well as introducing fun new tricks and activities to keep their mind occupied. I also have a few dog parks within walking distance of my apartment and plan on being a regular at those. | ||||||
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: |
I wouldn't do anything. I don't believe that negative reinforcement benefits the dog in any way. I think it's better to focus on encouraging the behavior you would like to see instead. | ||||||
Discipline: |
I had a lot of success with clicker training so I like to use that as it only focuses on positive reinforcement and instills trust and confidence in the dog to try new things during training. In the past I have used tools and things so that I always have food on hand as I believe that training is something that you are using to constantly bond with your dog. | ||||||
Where would Pembroke spend the majority of the time: |
Probably in my apartment as I do not have a yard at the moment. I will crate train the pup so that they always have a space where they feel safe, but I will not restrict them to any room or single space in my apartment. | ||||||
Discipline: |
I had a lot of success with clicker training so I like to use that as it only focuses on positive reinforcement and instills trust and confidence in the dog to try new things during training. In the past I have used tools and things so that I always have food on hand as I believe that training is something that you are using to constantly bond with your dog. Where would Pembroke spend the majority of the time: Probably in my apartment as I do not have a yard at the moment. I will crate train the pup so that they always have a space where they feel safe, but I will not restrict them to any room or single space in my apartment. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I work from home so I am around all day. | ||||||
Where would dog eat? |
I will have a bowl set out for them in the kitchen. | ||||||
Where would dog sleep: |
I will provide a crate for them to sleep in, but I will leave it open so that they can sleep in the bed with me if they'd like. | ||||||
Play & exercise: |
I work from home but I have a lot of downtime for short breaks throughout the day, so I plan on using that time to stimulate the dog if they are feeling up for it. When I was fostering my blue heeler, I had a lot of success spending about an hour in the morning at the dog park to tire them out for the morning and then either doing another 30-60 minute dog park session after work so that they have ample time off leash to stretch their legs. I will also take them on a 20 minute walk during lunch time. | ||||||
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? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
|
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 | ||||||
Willing to train children? |
I don't have children. | ||||||
|
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? |
I would be very careful about bringing new pets into the household without first making sure that they could get along with my Pembroke. If something were to occur, yes I would resolve the problem accordingly. | ||||||
|
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} | ||||||