Untitled_3615

Applicant IL
State: {Applicant State:2} Date of Application: 02/02/2021 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:
 1 year – 3 years
Gender preferred:
 Either a Male or a Female
Color preferred:
 Any color
Activity level:
 Couch Potato, Outgoing, Quiet, Playful, Energetic

Other preferences:
 I would like a dog with a good disposition, who likes people, is affectionate and likes to be cared for.

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?

 For me, Susan Klatt.

Why do you want a Pembroke?
 My granddaughter got a Welsh Corgi/Aussie mix puppy last July. I "babysat" BunnyBoy for 6 weeks while she was moving home from college, and love him for his charming personality, intelligence, and affectionate character.

Activities planned with Pembroke:
 Walking, playing ball (retrieving) being a couch potato. My dog would be a "house dog" — dogs cannot live outdoors in Wisconsin.

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: 		Say "No" in a firm tone of voice.

Discipline:
 Speak sharply, say "No" or "Down" or if necessary confine dog for a short period of time in my living room or bedroom.

Where would Pembroke spend the majority of the time:
 Wherever I am. It would be with me including riding in backseat of car if the weather permits and the dog appears to enjoy this.

Discipline:
 Speak sharply, say "No" or "Down" or if necessary confine dog for a short period of time in my living room or bedroom.
Where would Pembroke spend the majority of the time: Wherever I am. It would be with me including riding in backseat of car if the weather permits and the dog appears to enjoy this.

House dog or outside dog?

 House dog

People at home during the day?
 I'm retired, am a homebody, love gardening, have country property where my home is.

Where would dog eat?
 At one end of my kitchen.

Where would dog sleep:
 In a special bed next to my bed.

Play & exercise:
 By going for walks with me, playing "fetch," running around my yard and garden.

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?
 I have "Invisible Fence " which I have had for several years. The Invisible Fence people send a trainer to accustom the dog to the fence.

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:

 A country yard, (I have acreage). My home is a good distance away from a town road.
I do not have a swimming pool, pond, or anything that I believe would be hazardous to a dog.

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?
 Susan L. Klatt

Willing to train children?
 My children are grown and have families of their own. My son lives on adjoining property with his wife. His daughter lives 20 miles away with her family. My family, like me have been raised with dogs and horses.

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?
 Not applicable. I had a beautiful female Golden Retriever who died of cancer on August 25, 2020. She was 11 years of age, and my veterinarian told me that "Goldens" often do not live beyond 10 years.

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}