Untitled_3631

State: {Applicant State:2} Date of Application: 02/11/2021 Referred by: Friend
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, 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:
Playful

Other preferences:
good health, gets along with other dog and cats. likes a modest level of play.

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?

Me. I am an older male who lost his last companion June 1, 2020. I have lived in the same house in Ann Arbor since 1987. I have used the same vet with one change in ownership since 1987. Arbor Hills Animal Clinic. I have a fenced backyard of approx 5,000 sq ft. I am looking for a new companion and it can be an older but not an old dog. I am looking for a healthy dog with good attitude. Most of my dogs since 1987 have been mixed breed Labs.

Why do you want a Pembroke?
I have always liked the breed but have owned larger dogs 50 to 100 pounds since 1987. I am older now and want to move to a smaller companion

Activities planned with Pembroke:
Walks, play ball, be companionable with other neighborhood animals. I need the structured activity a companion dog will provide me.

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? No

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:
calmly, with encouragement to correct the mistake

Discipline:
verbal commands,


Where would Pembroke spend the majority of the time:
With me, in the house and in the fenced yard

Discipline:
verbal commands,
Where would Pembroke spend the majority of the time: With me, in the house and in the fenced yard

House dog or outside dog?

House dog

People at home during the day?
Yes, the owner (myself) is home all day (retired)

Where would dog eat?
In the kitchen, near the dining area in a quiet corner area

Where would dog sleep:
In the bedroom with the owner, either in bed or on the floor next to the bed in the corgi's own bed

Play & exercise:
Walks thru out the day, at least twice. Also, time spent the fenced backyard with balls and other dog friendly toys and play area

How will you exercise your dog?
On leash

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?
42inch chain link with 180ft of solid fencing (6ft height)

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:

1/4acre fenced yard (5000sf). 1 storage shed, fenced garden area (10X20), several large trees, lots of squirrels and birds

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?
Clark Richardson

Willing to train children?
not applicable, no 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?
not applicable – no other pets

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}