Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/14/2021 | Referred by: | 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: |
Outgoing, Playful, Energetic, Very Active |
Other preferences: |
|||||||
Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
Me (Julia) | ||||||
Why do you want a Pembroke? |
I've know that I want a dog in my life for quite some time now, having grown up with a dog at home. But I would love to adopt a Pembroke Welsh Corgi specifically because I love their personalities and energy. From the interactions I've had with corgis, I have found them to be playful, chatty, bold, and energetic. I feel that a dog with such a personality would align perfectly with who I am as a person and my lifestyle (I love to go for walks outside and be on the move). My experience with the breed has been meeting corgis in/around my home and on walks. I have done my research on the breed; I have been looking into adopting a Pembroke for about 6 months now. | ||||||
Activities planned with Pembroke: |
Going on walks, going to the dog park, corgi meetups, going to the Belmont Harbor Dog Beach (Chicago), playing at home, teaching new skills/obedience. | ||||||
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? |
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: |
I would try using a time-out if it's a single action they did (e.g. ripping up a shoe) or a continued action (e.g. barking). | ||||||
Discipline: |
If the Pembroke is biting something they should not be biting, I would redirect him/her to an appropriate channel for the behavior, such as a toy. If they are biting me or someone else, I would let out a short yelp followed by ignoring them for a short period to show that biting is not okay. If the Pembroke is engaging in some other negative behavior, I would ignore them for a while to not reinforce that the behavior is acceptable. And I will make sure the Pembroke gets plenty of exercise so that it has less of a reason to be bored/engage in destructive behavior. | ||||||
Where would Pembroke spend the majority of the time: |
With me in my apartment. | ||||||
Discipline: |
If the Pembroke is biting something they should not be biting, I would redirect him/her to an appropriate channel for the behavior, such as a toy. If they are biting me or someone else, I would let out a short yelp followed by ignoring them for a short period to show that biting is not okay. If the Pembroke is engaging in some other negative behavior, I would ignore them for a while to not reinforce that the behavior is acceptable. And I will make sure the Pembroke gets plenty of exercise so that it has less of a reason to be bored/engage in destructive behavior. Where would Pembroke spend the majority of the time: With me in my apartment. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I work from home most days. | ||||||
Where would dog eat? |
In my kitchen. | ||||||
Where would dog sleep: |
In a dog bed or with me, depending on corgi's preference | ||||||
Play & exercise: |
My building has a (fenced in) outdoor dog area, and I am two blocks from a park. I would take my corgi out multiple times a day to go to the bathroom in the dog area of my building and at least 2x a day for longer walks (morning and late afternoon/evening). He/she will get to play with other dogs at the dog area and at parks regularly, and he/she will get plenty of exercise through the longer walks multiple times a day. | ||||||
How will you exercise your dog? |
On leash | ||||||
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? |
|||||||
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? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
Not applicable | ||||||
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? |
Julia | ||||||
Willing to train children? |
Not applicable | ||||||
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? |
Not applicable | ||||||
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} |