Untitled_2927

Applicant IL
State: {Applicant State:2} Date of Application: 04/13/2020 Referred by: Website
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

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:
 Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active

Other preferences:
 We have 4 children. 5mo, 5yr, 8yr and 16yr so dog will have to be good with kids. We live on 20 acres so there is lots of space. We do not have a fenced yard.

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}

Who is this dog for?

 Me

Why do you want a Pembroke?
 I think they are absolutely adorable. I really want a small dog as an ESA and have done tons of research. Corgis make very good ESAs.

Activities planned with Pembroke:
 Go for walks, play in the yard, play in the house, snuggle

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

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: 		Scold him or her. If s/he is chewing on something their not supposed to I take away the item scold them by saying no or naughty. Once the dog is happy again I then would give them a toy or bone appropriate for chewing on.

Discipline:
 Scolding them, NOT yelling and redirecting the bad behavior or trying to teach them a good behavior to replace the bad.

Where would Pembroke spend the majority of the time:
 Free in the house

Discipline:
 Scolding them, NOT yelling and redirecting the bad behavior or trying to teach them a good behavior to replace the bad.
Where would Pembroke spend the majority of the time: Free in the house

House dog or outside dog?

 House dog

People at home during the day?
 Yes currently I am a SAHM that does PCA services for my autistic stepson.

Where would dog eat?
 If food aggressive s/he would be fed in his/her crate. If not then s/he would be fed in our dining room.

Where would dog sleep:
 On my bed or in his/her crate. Depends on the comfortablitlity of the dig.

Play & exercise:
 When it's nice outside I take my kids and my fur babies for long walks in the fields or down the road to visit my dad. If it's cold out then we would take a short walk outside. S/he would have lots of play time with myself or kids.

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:

 We have 2 enclosed pole sheds and 2 acres or yard. We are surrounded by fields and a wooded area behind the yard and field. We have a trampoline and swingset.

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?
 Teri – me

Willing to train children?
 Yes all my children except my infant already know the proper ways to treat 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?

 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, we are currently trying to rehome our bully because he is kid aggressive. We are extremely picky on his new owners which is why we still have him. We need to be certain he will be well taken care of and in a home with no kids.

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}