Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/24/2021 | Referred by: | Website | ||
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, Quiet, Playful, Energetic |
Other preferences: |
Good with animals and children. We have Rabbits and a cat. I also have a 7 year old. | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
Our family. | ||||||
Why do you want a Pembroke? |
I have not had direct experience with the breed. We love the family oriented characteristics of the Corgi. They are loving, family oriented, energetic, protective and easy to train. While personalities vary, they are down right adorable. | ||||||
Activities planned with Pembroke: |
Walks, playing: fetch, cuddling. | ||||||
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: |
This depends on the dogs personality. With my pit Bull, I was able to tap his nose and say no and he stopped. Not with pressure but to say: I’m here, listen to me. | ||||||
Discipline: |
I’ve never had a “bad” dog that resulted in full discipline. I trained my Pit, I took him to obedience classes to learn to calm him down. It took patience and stillness. As a example to get him to walk calmly, I would stand there until he calmed. When he was calm I would start walking. If he tried pulling in excitement we stopped walking. He learned through motion and treats to walk nice. | ||||||
Where would Pembroke spend the majority of the time: |
Any place he wants to go. We do not limit our house to our animals. They chose what room they want to be in. | ||||||
Discipline: |
I’ve never had a “bad” dog that resulted in full discipline. I trained my Pit, I took him to obedience classes to learn to calm him down. It took patience and stillness. As a example to get him to walk calmly, I would stand there until he calmed. When he was calm I would start walking. If he tried pulling in excitement we stopped walking. He learned through motion and treats to walk nice. Where would Pembroke spend the majority of the time: Any place he wants to go. We do not limit our house to our animals. They chose what room they want to be in. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I work from home. | ||||||
Where would dog eat? |
In the kitchen. I prefer food bowls to be in the kitchen. | ||||||
Where would dog sleep: |
In a pet bed with their own “living area”. Then all room doors open with steps to our beds so the cat can get up on the bed. | ||||||
Play & exercise: |
Throughout the day. We start our mornings with play and our evenings with play. Being home all day there is some during the day play. | ||||||
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: |
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: |
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Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We live on 1.5 acres. We have a cleared section and wooded section. | ||||||
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? |
Rebekka Venable | ||||||
Willing to train children? |
Yes, the cat and Rabbit were for my son. First when he was 3. He is very delicate and mild mannered with his pets and he was raised that way. He is also with my aunts Weenie dog daily, so he is familiar with how to act | ||||||
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? |
Yes. All animals need time to adjust and needs to be introduced gradually. | ||||||
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} |