Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 12/09/2020 | 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: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Energetic |
Other preferences: |
The home can be loud at times because of us talking loud when we get excited and joking around. Not yelling but my family and extended family has always been loud when we are just talking. We have a surround sound system on the TV and we watch movies at louder volumes at times and the Pembroke has to be good with cats. | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
The Pembroke is for my family. In my home lives my son, Bryce who is 22, his girlfriend, EvaAnn who is 19, and my daughter, Reece who is 18. We also have cats. we all work. However, Reece works afternoons, Bryce and I work days and currently EvaAnn is home all of the time due to loss of her job because of the current state of the economy. Even when she begins working again there is always someone home. I own my home, as well. | ||||||
Why do you want a Pembroke? |
I have done research and so have my children. The size of the breed fits our family. Not too small and not too big. The Corgi has been used for and have made great therapy dogs. They are kind and active. | ||||||
Activities planned with Pembroke: |
Walking, we have long trails by our house. Playing fetch and tug toys. | ||||||
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: |
Tell the Pembroke, "No" and redirect, followed by the best discipline method for the Corgi at that time. | ||||||
Discipline: |
Guiding the Corgi Dog classes, to learn the best and new ways exercising the Corgi daily to assist in releasing excited energies |
||||||
Where would Pembroke spend the majority of the time: |
In my house, access to all the rooms at all times. | ||||||
Discipline: |
Guiding the Corgi Dog classes, to learn the best and new ways exercising the Corgi daily to assist in releasing excited energies Where would Pembroke spend the majority of the time: In my house, access to all the rooms at all times. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
yes | ||||||
Where would dog eat? |
In our Kitchen. | ||||||
Where would dog sleep: |
whichever room they wanted and they would be aloud on the beds. I would have steps made so they could reach the beds. | ||||||
Play & exercise: |
Yes, and 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? |
No, I will not 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: |
currently I have a yard behind my home with a few trees. I will be purchasing the lot behind my home for more land. This backs up to a corn field and town park. There will be a fence, removal of the trees, a second garage, and an above ground pool but that is the five year plan. | ||||||
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? |
Karrie, Bryce, EvaAnn and Reece | ||||||
Willing to train children? |
all my children are adults. | ||||||
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, the cats will be slowly introduced to the Corgi assist with the adjustment. This will not deter us from keeping the Corgi . | ||||||
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} |