Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 01/06/2021 | Referred by: | Website, Other | ||
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, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
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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? |
Myself | ||||||
Why do you want a Pembroke? |
My original interest in Pembroke Welsh Corgis stems from the movie Murder She Purred that I watched as a child. Growing up I was involved in dog sports through 4-H and researched various breeds (at the time I had an English Setter). Recently my former 4-H dog sports club leader adopted a corgi and passed on some suggestions for research and where to inquire about corgi rescues. | ||||||
Activities planned with Pembroke: |
I live in Michigan's Upper Peninsula and frequently go walking by the lake and around town and on hikes, all activities I would like to share with my corgi. I currently work from home but even when working from the office I like to come home for lunch to work around the house or go for walks.
If it appeals to the corgi, I would make sure there are plenty of toys to play fetch or entertain the corgi. |
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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? |
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: |
Through training programs, I would take obedience classes with my corgi and use the verbal commands. If the mistake is something done in the house I would both modify my habits as needed (i.e., from dog sitting I learned not to leave my bite guard on the bedside table where a puppy could and did chew it) and work on the appropriate commands and training behavior to prevent the mistake in the future. | ||||||
Discipline: |
Verbal commands determined through training. | ||||||
Where would Pembroke spend the majority of the time: |
Home indoors, usually free in the house or sometimes in a crate for a reasonable time. Occasionally traveling with me to my parents' dog friendly home. | ||||||
Discipline: |
Verbal commands determined through training. Where would Pembroke spend the majority of the time: Home indoors, usually free in the house or sometimes in a crate for a reasonable time. Occasionally traveling with me to my parents' dog friendly home. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I am currently working from home and on days not working from home I come home for lunch. | ||||||
Where would dog eat? |
Designated spot in the kitchen. | ||||||
Where would dog sleep: |
Floor of bedroom. | ||||||
Play & exercise: |
Daily walks (already a current habit) once or more a day as needed. Landlord has approved adding a fence to the yard so the corgi can roam on the property outside. | ||||||
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: |
Rent/lease 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? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
The yard has no fixture, a temporary grill out in the summer. The yard is opened out to by back doors from apartments on the first and second floor. All residents of apartments in the house have confirmed they are alright with a dog on the property. A fence used to be in place for a basset hound that lived in the property and is no longer there. A fence would be erected again when a corgi comes to live in the house. | ||||||
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? |
Elizabeth Fust | ||||||
Willing to train children? |
Yes. Currently I have two nephews who live with a dog and I would introduce them (and their dog) to my corgi as they visit frequently and I often dog sit. | ||||||
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? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
Yes. I would introduce all dogs/pets before adopting an additional animal, if that ever came up, to determine if 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} |