Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 06/18/2020 | 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, Any color | Activity level: |
Couch Potato, Outgoing, Playful, Energetic, Other (Please describe in the box below.) |
Other preferences: |
The most important thing is that the dog has to be friendly towards other animals and outgoing. | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
It is for me and my family. My family consists of 3 adults, one kid, and a guinea pig. We want the dog to be part of our family. | ||||||
Why do you want a Pembroke? |
I have been wanting to adopt a dog for over a year now and so I have been doing my research to find the breed that I think is the best one for me and I am sure that the Pembroke Welsh Corgi is the perfect fit for me. I love that they have the best of both worlds, they are a medium-size dog that can adapt easily to different environments which is great because they are not as hard to take care as it will be with a bigger breed, but their size do not stop them. They have the energy and personality of a big dog which is what I was looking for too. I want a dog that is intelligent, sweet and that likes to play but I also wanted a dog that was not too big or too little, so that was also what attracted me to the Pembroke Welsh Corgi. So I have been doing my research for the last couple of months, I know about their coat and that they shed seasonally, which is not a problem for me. I also know about all the genetic diseases that they can have, which is why I am looking for a healthy corgi. |
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Activities planned with Pembroke: |
I would like to cuddle and watch movies, go to a dog park, leash walks, and going for runs. I also want to do a lot of activities inside the house with the dog. | ||||||
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 will handle with positive reinforcement. I don't believe in using force or in yelling. If the dog makes a mistake I will be patient and keep training him/her. | ||||||
Discipline: |
Positive reinforcement, treats, games, and patience. My family and I have experience training dogs without using force or any negative way of training. | ||||||
Where would Pembroke spend the majority of the time: |
With me in our house, inside or in the backyard. On occasions where I have to go out, my corgi will stay with my mother. | ||||||
Discipline: |
Positive reinforcement, treats, games, and patience. My family and I have experience training dogs without using force or any negative way of training. Where would Pembroke spend the majority of the time: With me in our house, inside or in the backyard. On occasions where I have to go out, my corgi will stay with my mother. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, my mother is at the house all day and I am at home most of the day except when going to my college classes. | ||||||
Where would dog eat? |
In the kitchen. | ||||||
Where would dog sleep: |
In my bedroom, I am creating a space for my corgi to sleep next to me. | ||||||
Play & exercise: |
We will go to parks so she/he can socialize with other dogs and make some friends. We will also play together in my backyard and go for walks and hikes. My corgi will exercise at least once a day, depending on his/her energy but we will do it daily. | ||||||
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: |
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? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We have a big backyard with a lot of trees and plenty of space to run, we do not have a fenced yard at the moment but we will put one soon. We have a trampoline and a bonfire but since the yard is really big we still have plenty of space. | ||||||
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? |
Chiara | ||||||
Willing to train children? |
Yes, we do it a lot because we already have a guinea pig. Elena is very gentle, sweet, and respectful towards 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, I am willing to work with my corgi and my current/future pets so they get along. | ||||||
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} |