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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years | Gender preferred: |
Male | Color preferred: |
Red & White | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
Playful with our friendly 4 year old goldendoodle | ||||||
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 and Brian | ||||||
Why do you want a Pembroke? |
I want to adopt a Welsh Corgi because I have done a lot of research on them. I am looking for a companion for myself and for my dog Lilly. During the summer, my family likes to boat on Lake Michigan and swim. So we started looking for smaller dogs that are easy to travel with and love the water as well as get along with other dogs and people. I have read that they are very smart and well behaved. I have known a few people that have corgis and they absolutely adore them and cannot say enough good things! | ||||||
Activities planned with Pembroke: |
Boating, swimming, walks. I am even able to take my dog to work with me the days I work at our family business! | ||||||
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: |
Discipline when catching them in the act of them doing wrong. Whenever lilly was misbehaving, I would scold her and place her in her cage for 30 minutes. I never hit her and I do not believe in that. She never went to puppy school and is a very well behaved dog. | ||||||
Discipline: |
Changing tone of voice and pointing at the mistake the dog made, placing them in their cage afterwards for a short period of time to separate them from toys and people. | ||||||
Where would Pembroke spend the majority of the time: |
Inside the house or with my parents | ||||||
Discipline: |
Changing tone of voice and pointing at the mistake the dog made, placing them in their cage afterwards for a short period of time to separate them from toys and people. Where would Pembroke spend the majority of the time: Inside the house or with my parents |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No. Brian and I have different work schedules and are home at different times. The dogs would not be alone for more than 6-7 hours. | ||||||
Where would dog eat? |
In the lower level of the house, with my other dog | ||||||
Where would dog sleep: |
In our bedroom. Lilly usually sleeps in bed with us. We would also get him his own dog bed | ||||||
Play & exercise: |
We have a large fenced in back yard in a neighborhood with other dogs. Lilly spends a lot of time playing and running outside during the summer. We also go boating every weekend during the summer where Lilly is able to play in the lake. He will get to play throughout the day with Lilly and with us when we get home from work. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
Fenced yard? |
Yes, I have a fenced in yard. | ||||||
Willing to pick up dog waste? |
Yes, I will clean up after my dog. | ||||||
Willing to use a crate? |
Wrought iron | ||||||
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: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
No fixtures. Large wide open backyard | ||||||
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? |
Brian | ||||||
Willing to train children? |
Yes. However, we do not have kids | ||||||
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 | ||||||
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} |