Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 07/27/2021 | 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, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, 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? |
Ryan & Kathryn | ||||||
Why do you want a Pembroke? |
Family and family friends have owned Pembroke Welsh Corgis for years that we watch on a regular basis (aged between 1-6 years old). We are a young active couple under 30 years old that have been waiting for the right time to get an animal with adequate space which we now have. We have done thorough research and found Lakeshore Pembroke Welsh Corgi Rescue through the AKA. We enjoy the energy and compassion Corgi's have for their owners as well as other humans living in a populated areas. We have had several types of dogs growing up (greyhounds, golden retrievers, etc.). We have the financial means, time and living arrangements to support having a Corgi in our home. | ||||||
Activities planned with Pembroke: |
Daily walks, trips to the beach (we live near Lake Michigan), trips to dog parks (live within 1 mile of 3 different dog parks), trips to local Chicago suburbs to visit family | ||||||
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: |
We subscribe to positive dog training methodology. The Corgis we regularly watch were trained using positive dog training methodology and are extremely well behaved. Dogs should be rewarded for good behaviors, but never hit or yelled at. | ||||||
Discipline: |
We subscribe to positive dog training methodology. The Corgis we regularly watch were trained using positive dog training methodology and are extremely well behaved. Dogs should be rewarded for good behaviors, but never hit or yelled at. | ||||||
Where would Pembroke spend the majority of the time: |
Anywhere within the apartment or private outside area. | ||||||
Discipline: |
We subscribe to positive dog training methodology. The Corgis we regularly watch were trained using positive dog training methodology and are extremely well behaved. Dogs should be rewarded for good behaviors, but never hit or yelled at. Where would Pembroke spend the majority of the time: Anywhere within the apartment or private outside area. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. Ryan works from home full-time and Kathryn works 3 days a week as a nurse. There would always be someone home with the dog. | ||||||
Where would dog eat? |
In a designated area of the kitchen where the dogs food and water dishes would reside. | ||||||
Where would dog sleep: |
On its own dog bed in our bedroom. | ||||||
Play & exercise: |
Several times per day. We live within 1 mile of three dog parks and live near Lake Michigan. Our neighborhood is extremely dog friendly and we exercise already daily as a couple on 3-6 mile walks. | ||||||
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: |
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: |
We live in a 2 bedroom, 2 bathroom apartment with a private deck that is only accessible to our apartment. The deck has a 3.5 foot fence along the outside and a 6 foot tall privacy fence on each side. The outside area is approximately 400 sq. feet of additional outdoor space that is only accessible to us. | ||||||
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? |
Both Ryan and Kathryn | ||||||
Willing to train children? |
N/A – no children or planned children in near future. | ||||||
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? |
N/A – no other pets | ||||||
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} |