Untitled_3501

Applicant IL
State: {Applicant State:2} Date of Application: 12/12/2020 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
Gender preferred:
 Either a Male or a Female
Color preferred:
 Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color
Activity level:
 Outgoing, Playful, Energetic

Other preferences:

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?

 Myself

Why do you want a Pembroke?
 I have not had a Corgi but always admired the breed. I am a dog lover: raised with Golden Retrievers. As an adult, I have had and loved an Irish Water Spaniel, a Springer Spaniel, a Scottish Terrier, my husband ( deceased) and I raised English Bull Terriers. Most recently since 2008 I have loved two different “American Mixed Breed Shelter dogs.” One was predominantly Husky. Most recently I had and loved a “Bully Breed Mix.” I adopted both when they were adults and loved them much until old age and their health issues robbed them of any quality of life.

Activities planned with Pembroke:
 I live in the country with a 1/2 acre fenced in back yard. The fence is 5 ‘ high. It is a wonderful setting for a companion dog. I am73 yrs young, walk daily – especially important during Covid. I have never been without a dog for more than a few months.

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: 		Consistancy in correction; tone of voice; one word. Praise, smiles, love and upbeat tone of voice after correction. No physical punishment, no shaming, no confusing a dog with a person.

Discipline:
 See above

Where would Pembroke spend the majority of the time:
 In the house or back yard, on walks, riding with me. However, I do not take dogs in cars when weather is cold or during excessive heat.

Discipline:
 See above
Where would Pembroke spend the majority of the time: In the house or back yard, on walks, riding with me. However, I do not take dogs in cars when weather is cold or during excessive heat.

House dog or outside dog?

 House dog

People at home during the day?
 Myself

Where would dog eat?
 In my kitchen

Where would dog sleep:
 On my bed or in a dog snoozer in my room or on a cushy dog bed in my living room.

Play & exercise:
 Wonderful setting outside in back yard. My son’s family lives on same road and I have a delightful 5 year old granddaughter who would be great fun for a Corgi and vice versa. I would walk my dog – leashed – a few miles a day on these quiet country roads or at the local one mile track at Almira Township Park – always leashed.

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?
 5’ high, solid board on two sides and chain link access the back. The access is through dining area patio doors onto a large deck. The outside gate access is always closed – I am totally diligent.

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:

 Again – it is close to 1/2 acre and totally fenced for privacy on two sides and chain link in the back. Other than the large deck, there are no fixtures except for a bird bath and a bird feeder pole. The back yard is cleared, I mow it in the growing months. There are plenty of trees for shade.

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?
 Martie Manty

Willing to train children?
 Absolutely. My son and his wife and I are of one voice about this important part of raising children.

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?

Are you willing to work on it if your new dog doesn’t get along with your current pets right away?
 NA

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}