Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 04/03/2021 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
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? |
For myself and as a companion for my corgi, Oslo. | ||||||
Why do you want a Pembroke? |
I want to adopt another PWC as a play mate for my current corgi as well as I just love the breed. Their personalities are simply adorable. Definitely a challenge as far as obedience work and being willing to do what is asked but that is just the breed. | ||||||
Activities planned with Pembroke: |
We would go for regular walks, attend obedience classes, doggie daycare. Lots of socializing with other dogs and people. | ||||||
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: |
Scold and redirect to acceptable behaviors. | ||||||
Discipline: |
Obedience training including redirecting bad behavior with good behaviors, scolding as needed by vocalizing NO or leave it. My dogs are expected to behave and I work hard at making them good canine citizens including earning their CGC title. | ||||||
Where would Pembroke spend the majority of the time: |
When unsupervised, probably crated until trust has been developed to allow being allowed to remain out of crate while we are away. | ||||||
Discipline: |
Obedience training including redirecting bad behavior with good behaviors, scolding as needed by vocalizing NO or leave it. My dogs are expected to behave and I work hard at making them good canine citizens including earning their CGC title. Where would Pembroke spend the majority of the time: When unsupervised, probably crated until trust has been developed to allow being allowed to remain out of crate while we are away. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Currently my husband is not working and attending school so he is home a lot so very minimal times of no one home with the dogs. | ||||||
Where would dog eat? |
In the kitchen with the other two dogs. Always supervised because my current corgi likes to get sassy when he’s eating and I have to pick up his dish and remind him that he’s not the boss and needs to just eat his food and not cause issue with my lab. Issue in that he tries to steal his food or bark at him. Nothing major just more of an annoyance. | ||||||
Where would dog sleep: |
Again until trust is established the corgi would sleep in a crate. Once that trust is established then probably would sleep with my current corgi on a dog bed in our bedroom. | ||||||
Play & exercise: |
We have a fenced in yard for lots of outdoor time to run around and explore. I also walk my dogs regularly, take them to obedience and agility classes as well as doggie daycare once a week. | ||||||
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 chain link fenced around our entire backyard. | ||||||
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: |
Large fenced in backyard with plenty of room to run, play and explore. | ||||||
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? |
Barbara Templin | ||||||
Willing to train children? |
No children in the house however we socialize our dogs a lot to be good canine citizens so they do get exposure to children and are expected to behave themselves and if they act up we use this as a teaching moment for the dog so we curb bad behavior but reward good behavioe. | ||||||
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. I adopt for the life of the animal. I will work with the dog however long it needs to succeed in our home environment. | ||||||
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} |