Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/28/2021 | 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Playful |
Other preferences: |
|||||||
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? |
Us the newly wedd couple | ||||||
Why do you want a Pembroke? |
I like big dogs and she likes little dogs so corgis were the compromise. Medium sized and adorable! Plus cheddar(the corgi) is awesome on the tv show Brooklyn 99. Plus we both follow a lot of corgi pages and her sister owns a corgi in California. It’s the breed we both love and want to have in our life | ||||||
Activities planned with Pembroke: |
We would love to go on hikes with our dog. Take them camping or to parks. We have a fenced in back yard for them to round around in. And we want a cute little buddy to cuddle with and one day be our future child’s friend growing up | ||||||
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: |
If it’s not to late use a low tone, not yelling. And mostly by training them positively through affirmation and treats | ||||||
Discipline: |
Mostly keep teaching them through positive experiences like classical conditioning aka treats and affirmation when they do the right thing | ||||||
Where would Pembroke spend the majority of the time: |
In the house or backyard | ||||||
Discipline: |
Mostly keep teaching them through positive experiences like classical conditioning aka treats and affirmation when they do the right thing Where would Pembroke spend the majority of the time: In the house or backyard |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I have flexible work hours and can be home whenever I choose. And I usually get home around 5 | ||||||
Where would dog eat? |
In the kitchen at his/hers food bowl | ||||||
Where would dog sleep: |
In a dog bed or possibly our bed if my wife talks me into it. | ||||||
Play & exercise: |
We would take them on plenty of walks. Or hikes. Love to go exploring in nature. We have a back yard for them to play in as well that’s fenced in. And they could play with my brothers dogs (Australian shepherd and border collie) | ||||||
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? |
Wooden fence on one side. Tall stone retaining wall to the back. And a wooden fence on the other side with a chain link fence behind that | ||||||
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: |
No swimming pools. Just a plain grass yard, fenced in. No plants or bushes. But there is a tree that shades most of the backyard. No pools or extra things | ||||||
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? |
Dante Navarrete | ||||||
Willing to train children? |
Yes | ||||||
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? |
Yes although we don’t have any pets currently | ||||||
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} |