Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/23/2021 | 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: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
We currently have 1 Pembroke Welsh Corgi, Walter, who is 2.5. We have had him since 7 weeks. The Corgi we adopt would need to do well with other dogs and cats as my (Dustyn) parents have a cat. | ||||||
Dog Ownership History | |||||||
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} | ||||||
Questions Regarding Motivation for Adopting and Intentions | |||||||
Who is this dog for? |
Dustyn and Shawn | ||||||
Why do you want a Pembroke? |
I (Dustyn) have always been pro adoption. There are so many animals out there that need homes that often get overlooked for a new puppy. I would love the opportunity to give a little guy or girl a happy home and lots of loves. We fell in love with the quirkiness and personality of Corgis at young ages. Walter is our first together, however, Shawns family has had several while he was groing up. | ||||||
Activities planned with Pembroke: |
We are relatively active with Walter now. Playing fetch, catch, etc. In the backyard and going on a walk around the neighborhood or neighboring parks/lakes nearby as long as the weather allows. If it's raining, snowing, or too cold we head down to our large and open basement to zoom around and play fetch to get exercise daily. | ||||||
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? |
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: |
It depends on the situation that is occurring as different acts cause for different actions. Mistakes happen but it is important to react in a positive and coaching manner. Positive interrupter to redirect the dogs attention if they are chewing on something they shouldn't, teach a word or noise to halt the mistake, training to avoid the mistake from happening in the future. | ||||||
Discipline: |
Walters discipline comes mostly from chewing or getting into things he shouldn't (i.e. a loose shoe, blanket, rug, etc.) For this we are sure to address the situation quickly by offering his favorite toy, using the phrase "leave it", or if he is ignoring us completely we have a timeout bed where we will tell him to go to his place and stay. | ||||||
Where would Pembroke spend the majority of the time: |
I (Dustyn) work from home so Walter and our future little one will be with me all day. Walter mostly hangs out with me in the office or living room indoors or trots around the fenced in backyard to soak up the sun in nice weather | ||||||
Discipline: |
Walters discipline comes mostly from chewing or getting into things he shouldn't (i.e. a loose shoe, blanket, rug, etc.) For this we are sure to address the situation quickly by offering his favorite toy, using the phrase "leave it", or if he is ignoring us completely we have a timeout bed where we will tell him to go to his place and stay. Where would Pembroke spend the majority of the time: I (Dustyn) work from home so Walter and our future little one will be with me all day. Walter mostly hangs out with me in the office or living room indoors or trots around the fenced in backyard to soak up the sun in nice weather |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I (Dustyn) works from home the majority of the time unless I have a business meeting that requires me to travel to the office or a customer's business. | ||||||
Where would dog eat? |
We have Walter's food and main water station setup by our dining room table so he can eat with us. | ||||||
Where would dog sleep: |
Walter has slept in our bed since he was about 2 months old. The adopted Corgi would have the option to sleep in the king sized bed as well or on the large dog bed in our room. | ||||||
Play & exercise: |
Walter and I play outside in the yard on lunch and go for a long walk after work is done. On the weekends we are constantly playing ball/Frisbee and go on 1 long walk or 2 shorter ones around the neighborhood a day. | ||||||
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? |
We have a 4ft solid vinyl pee our HOA's requirements. When we installed it we requested it to be as close to the ground as possible as Walter was a very small puppy. | ||||||
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? |
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Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We have a medium sized fenced in backyard. There aren't any fixtures or hazards. Just a deck! | ||||||
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? |
Dustyn and Shawn care for Walter equally. | ||||||
Willing to train children? |
We do not have children and don't have plans in the near future to adopt. If child does com into our life we will absolutely take the time to teach them how to care for an animal properly. | ||||||
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? |
Absolutely. If we are lucky enough to adopt a new little one it is our primary goal to ensure both they and Walter can live peacefully together whether that be instantly or with training and guidance. | ||||||
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} |