| Date & Referral Source | |||||||
| State: | Date of Application: | 08/19/2017 | Referred by: | Website | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
| Address | |||||||
| Street: | |||||||
| City: | State: | Zip: | |||||
| 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, Playful |
Other preferences: |
no problem with disabled corgis | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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Dog 1 name: |
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Dog description: |
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How long owned? |
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Where is this dog now? |
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| Dog 2 | |||||||
Dog 2 name: |
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Dog description: |
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How long owned? |
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Where is the dog now? |
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| Dog 3 | |||||||
Dog 3 name: |
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Dog description: |
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How long owned? |
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Where is dog now? |
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| Dog 4 | |||||||
Dog 4 name: |
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Dog description: |
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How long owned? |
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| Where is this dog now? | |||||||
| Questions Regarding Motivation for Adopting and Intentions | |||||||
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Who is this dog for? |
for myself and my husband… We have a 1 year old female corgi, and a male rescue corgi/terrier mix 2 yrs. old. We had 2 male corgi for 14 years..we lost them both a week apart in November 2015 from a tumor that burst in their abdomen. 2 heartbreaking weeks later we rescued Sparky (corgi/terrier mix). Then 2 weeks after that we purchased a female corgi , Abby. Breeders are asking for alot of money for a corgi puppy…so we thought about adoption. We don't have children (2 legged children). We have a big back yard that will be fenced in next year. |
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Why do you want a Pembroke? |
I love corgis…they have a happy personality that always gets me out of my worse moods. My dogs are my children, I have photos of them everywhere in my house, car, on my cell phone. We give our corgis middle names (Abby Lynn, Sparky Lea). We'd rather be at home with the pups sitting on the couch watching wrestling then to go on vacation or to the movies. Before we brought home Pixel 16 years ago we read every book, talked to our vets in town, and gathered all the information we could to prepare for Pixel (our first Corgi). |
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Activities planned with Pembroke: |
I walk my corgis multiple times everyday. We are teaching Sparky how to retrieve things ..he retrieves his leash and my work shoes, and sandals. My husband will point to the leash or shoes, and we ask Sparky to "bring it"..its a work in progress, but he has done it a few times. We crate trained them so when we leave they go to their crates. We don't leave them in there for long periods of time. We've tried to teach them to fetch a ball…work in progress. I've taught all my corgis (all 4) on our walks to stop at a crosswalk, to cross when safe with direction from me. My corgis are also house trained, but we have pads down for accidents during the night. |
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Aware that Pembrokes are busy, noisy dogs? |
Yes | ||||||
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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: |
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Will handle mistakes Pembroke makes like this: |
calmly | ||||||
Discipline: |
say No..and try it again | ||||||
Where would Pembroke spend the majority of the time: |
with us | ||||||
Discipline: |
say No..and try it again Where would Pembroke spend the majority of the time: with us |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
the longest that either one of us is out of the house is 4 hrs. at the very most | ||||||
Where would dog eat? |
in their crate | ||||||
Where would dog sleep: |
in our bedroom with us probably on the bed like our other corgis…Abby usually sleeps under the bed below me..my Gizmo did the same | ||||||
Play & exercise: |
we go for long walks, or play in either a pen area like a dog park (I usually go to a nearby dog park when its empty). they can have all the time to play ..when one of us is home they are free rain of the house | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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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: |
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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 | ||||||
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Description of yard: |
fairly large back yard, no swimming pool, a big pine tree, garage in the corner, pretty open with a small garden on the side. | ||||||
Household members: |
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Everyone in household agrees about adopting a corgi? |
Yes, everyone agrees and wants to adopt a Pembroke Welsh Corgi. | ||||||
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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? |
Christina and Jason | ||||||
Willing to train children? |
I do not have any children..I had a full hysterectomy 10 yrs. ago due to Ovarian and endometrian cancer | ||||||
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Any allergies? |
No one is allergic. | ||||||
Current pets: |
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Current pets dog friendly? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
yes I will teach everyone to get along | ||||||
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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. | ||||||
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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: |
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