Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 05/21/2020 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Playful |
Other preferences: |
We would need to have a Pembroke that is good with other dogs/not being in a solo household. | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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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? |
The Pembroke would be an addition to our family. Alex has a dog before started dating, and I have come to fill the 'mother' role for our boy Bruce. Bruce is a 3-year old rescue cattle dog that LOVES other dogs. We are interested in adopting a second dog that would be loved by all three of us. | ||||||
Why do you want a Pembroke? |
I have always been a small dog fan, and after living in the Andersonville area, we see many corgi's out on walks with our dog. I love the personalities that come from the corgi's we see. We are a family of diverse and loud personalities, so finding a pup that would fit into that mix is important. Since Pembroke's are headers by nature, the addition to our family, may it be loud, would be full of energy and love. | ||||||
Activities planned with Pembroke: |
We would like to have an active outdoor life, with going on walks and out to patios with our pet. We enjoy going to the dog park to socialize and currently send Bruce to day care a few times a week on our longer days to ensure that he is not feeling lonely, and we would continue to do this as well with a new addition.
We have a gated back yard that we use for fetch as well. |
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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: |
I predominately use verbal reprimands. I am not a fan of corporal punishment. I have tapped our current dog on the head before. | ||||||
Discipline: |
As above, I try to only use verbal reprimands and the only times I have used force against our current dog is light taps on the top of his head. | ||||||
Where would Pembroke spend the majority of the time: |
The Pembroke would spend most of their time in the house with our other dog. | ||||||
Discipline: |
As above, I try to only use verbal reprimands and the only times I have used force against our current dog is light taps on the top of his head. Where would Pembroke spend the majority of the time: The Pembroke would spend most of their time in the house with our other dog. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
My partner and I are finishing our last year of law school so our schedule for the next year is very open and we are in and out of the house at more random hours during the working day. Starting in Fall 2021, we will have a more traditional hours, however, we will likely increase the amount of day care hours when we come to that point. | ||||||
Where would dog eat? |
Our corgi would eat in the kitchen. | ||||||
Where would dog sleep: |
The adopted corgi would be welcome to sleep in the bed with my partner and I. However, we will have a doggie bed to allow the Pembroke the choice of having their own space if they prefer it. | ||||||
Play & exercise: |
Utilizing day care allows for a lot of stimulation throughout the week. At home, the corgi would have a live in friend for entertainment. As a family we enjoy going on walks and seeing friends. My partner's parents live nearby and have two elderly collie's we often visit as well. | ||||||
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? |
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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: |
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Landlord permission: |
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Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We are in an owned apartment. The backyard is completely fenced but it all concrete. | ||||||
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? |
Lauryn | ||||||
Willing to train children? |
Yes we would. Alex and I are not in the place to have a child any time soon. If we were to decide to have a child, said child would be taught how to properly care for 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. Relationships take time and you cannot force a new friend on a person or a dog. | ||||||
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} |