Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 05/25/2021 | 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: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Playful |
Other preferences: |
This dog will be a companion for my current 9-year old friendly lab mix. He/she should be happy to share living arrangements with a cat. I've always had both cats and dogs. | ||||||
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? |
Myself, Nancy Homes | ||||||
Why do you want a Pembroke? |
I have never owned a Corgi. I'm looking for a small calm (relatively) dog to join the family. It's hard to find a good small dog to adopt; anything that's available goes very quickly, and the cuter, the faster. My pockets are not deep enough to buy from a breeder. | ||||||
Activities planned with Pembroke: |
Leash walking and playing in the enormous green space that belongs to this retirement community. I have owned a Sheltie before, and I think there are some breed comparisons with Corgis. | ||||||
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: |
Everybody makes mistakes. Reassure the dog and cheerfully move on. The | ||||||
Discipline: |
I encourage good behavior by rewarding it with lots of praise and encouragement. If a dog understands what you want, he/she is likely to respond in the right way. Repetition and consistency will reinforce what you are trying to teach. | ||||||
Where would Pembroke spend the majority of the time: |
Either in my apartment or outdoors with Missy and me. We have long sidewalks and enormous green space. | ||||||
Discipline: |
I encourage good behavior by rewarding it with lots of praise and encouragement. If a dog understands what you want, he/she is likely to respond in the right way. Repetition and consistency will reinforce what you are trying to teach. Where would Pembroke spend the majority of the time: Either in my apartment or outdoors with Missy and me. We have long sidewalks and enormous green space. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I'm retired, so I'm home a lot. For the first week or ten days, I would plan to be home most of the time. | ||||||
Where would dog eat? |
A good kibble. Any special dietary needs would be attended to. | ||||||
Where would dog sleep: |
I would try the crate at first. I'm flexible and adaptable in sorting out whatever gets us all through the night. The crate is my first choice. | ||||||
Play & exercise: |
Three walks a day. I walk my present dog three times. I also walk a dog for one of the residents here. In the summer there is plenty of green space (with a second person on hand) to run around and chase a ball. Winter is a different story, but we do the best we can. | ||||||
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? |
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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? |
Yes | ||||||
Description of yard: |
I don't live in a house, I live in an apartment. There are no fences and no swimming pools. | ||||||
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? |
Nancy Homes | ||||||
Willing to train children? |
There are no children or grandchildren in the family. | ||||||
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. I raised my children on a farm in Canada. I had five cats and two dogs and no problems that couldn't be solved with a little time and effort. | ||||||
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} |