Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 02/04/2022 | 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: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
Dog 1 |
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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? |
My family and myself | ||||||
Why do you want a Pembroke? |
As with most people I have always been drawn to the adorable appearance of the Corgi and I want to be transparent. Upon further research, I also found they are a great fit for my lifestyle. When thinking about a dog I want one that I am able to take on walks and play with but that does not have so much energy I would not be able to keep up with them. As someone who has grown up with dogs, I also know that corgis tend to be characterized as "fun-loving, and easygoing" which would fit right in with my lifestyle. I am aware that there are health concerns with this bread and that they were originally bred to be herd animals. Both of these have been taken into consideration when deciding to apply. | ||||||
Activities planned with Pembroke: |
As stated before I have done a significant amount of research and the first thing I would want to do is begin training classes with the dog. I would ideally want them to be able to be social with other dogs during these classes (covid permitting) as I know they are social animals. I would also commit to being outside with them daily in order to help them expel energy and get exercise. I also would simply enjoy being with my dog, providing them with love, attention, and toys. | ||||||
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: |
I think it would be imperative to stay calm and try to work more on positive rewards and reinforcement. I would also make a note that it was something I, as the owner, would need to work on in training. | ||||||
Discipline: |
I would try to be consistent and redirect. For instance, I would reward for positive behavior and try to not give much attention to the negative in order to keep my pet focuses on the rewards and doing the things to get those said rewards. | ||||||
Where would Pembroke spend the majority of the time: |
The dog would be able to have free roam of the house while we were home and I would work to crate train them for when we are not there. | ||||||
Discipline: |
I would try to be consistent and redirect. For instance, I would reward for positive behavior and try to not give much attention to the negative in order to keep my pet focuses on the rewards and doing the things to get those said rewards. Where would Pembroke spend the majority of the time: The dog would be able to have free roam of the house while we were home and I would work to crate train them for when we are not there. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
My partner is home most days until 4 pm and I return from around 6 pm. | ||||||
Where would dog eat? |
In the kitchen. | ||||||
Where would dog sleep: |
They would have dog beds available to them in multiple rooms as well as a crate. We would allow them on the furniture as well. | ||||||
Play & exercise: |
We would go on daily walks in the evening or morning (depending on the weather) as well as provide plenty of time for them to run around outside at a local park or in our yard. | ||||||
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: |
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? |
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Lease allow dogs: |
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Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We have a nice-sized backyard with lots of trees. We would like to put up a fence but that has been postponed due to supply issues | ||||||
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? |
Caitlyn | ||||||
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? |
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. We have had a dog stay at our home for a while and we worked with the cats and dogs to be able to live together. | ||||||
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, [email protected], friend.:87} |