Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 07/10/2021 | 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
Hi there! This Pembroke is for my wife and I. We've are keen on adding a Corgi to the family and would love to adopt from from the Lakeshore rescue. | ||||||
Why do you want a Pembroke? |
Both my wife and I grew up with large dogs, including labradors, large terriers, and a shepherd. We've always been used to having pets with robust personalities and are looking for a dog that can be an active, and fun-loving part of our family. We've fallen in love with the pembroke corgi after our many interactions with the breed while living in Chicago. We researched a multitude of breeds and feel the corgi's temperament would be the best fit for our lifestyle and dog-experience. | ||||||
Activities planned with Pembroke: |
Madeleine and I live next to Lake Michigan and love to go for walks or short runs along the lake. We are keen on taking short trips out of the city to go on day hikes and visit the outdoors. Madeleine is also a passionate swimmer, granted we don't have much water access for a majority of the year given temperatures here! One of our favorite parts about corgis are their sturdiness and energy in a compact package :). We understand how important it is for corgis in particular to get their workouts in each day in order to avoid health issues and obesity. | ||||||
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: |
Madeleine and I are both firm believers in positive-reinforcement, finding opportunities to reward the right behaviors and not create a negative/punishment centric relationship that could lead to future unwanted behaviors. In our experience with our previous dogs, we have found that redirecting a dog's attention to the correct behavior to be most effective in making long-term behavior changes. For example, if a dog is chewing on carpet, we could direct its attention to a chew toy instead. | ||||||
Discipline: |
As mentioned above – we believe training and disciplining a dog should be focused on rewarding good behavior and re-directing any negative behavior without aggression or harmful actions. I've seen how negative and angry discipline can damage a dog long-term and want to foster a leadership dynamic focused on respect, and not fear. | ||||||
Where would Pembroke spend the majority of the time: |
Madeleine and I live in a two bed condo with a fenced in shared-yard. Our Pembroke would likely spend most time inside with us while not on walks, playing in the park, or taking breaks in the yard. | ||||||
Discipline: |
As mentioned above – we believe training and disciplining a dog should be focused on rewarding good behavior and re-directing any negative behavior without aggression or harmful actions. I've seen how negative and angry discipline can damage a dog long-term and want to foster a leadership dynamic focused on respect, and not fear. Where would Pembroke spend the majority of the time: Madeleine and I live in a two bed condo with a fenced in shared-yard. Our Pembroke would likely spend most time inside with us while not on walks, playing in the park, or taking breaks in the yard. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Typically – I work at a company that allows me to work from home the majority of the week, with some light travel throughout the year. Madeleine's job requires her to work until 3pm, so the longest a dog would need to be home alone on rare occasion would be 5 hours max. We also have a strong network of neighbors with pets who would be able to provide attention for our Pembroke on these occasions. | ||||||
Where would dog eat? |
My goal would be to keep the dog's eating space separate from where we keep and cook food, to allow for mental separation between human food and dog food. We have a nook that would be suitable and is a decent distance from our kitchen space. | ||||||
Where would dog sleep: |
As I mentioned above – we would create a designated area that was considered the corgi's "room," where it would sleep at night. We have a space set aside for this in our master bedroom. | ||||||
Play & exercise: |
The corgi will get to exercise each, in either the morning, evening, or both. Madeleine and I typically spend an hour+ outside each 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? |
Our condo has a shared yard circled by brick walls and one large metal gate, about 7 feet tall. | ||||||
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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
I do not live in a house. | ||||||
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? |
Garrison Krotz | ||||||
Willing to train children? |
We do not have children – but when we do (fingers crossed) we plan on teaching them about respective all living creatures. | ||||||
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! While it's unlikely we will add a second dog to the family in the next five years, we would be excited to have that as a possibility. | ||||||
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} |