Date & Referral Source | |||||||
State: | Date of Application: | 10/04/2017 | Referred by: | Website, Friend | |||
Contact Information | |||||||
First name: | Last name: | First name 2: | Last name 2: | ||||
Address | |||||||
Street: | |||||||
City: | State: | Zip: | |||||
Type of Dog Wanted | |||||||
Ages interested in: |
0 months – 1 year (we rarely get dogs in this age group) | Gender preferred: |
Male | Color preferred: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White | Activity level: |
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: |
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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 | |||||||
Who is this dog for? |
Being a forever family member | ||||||
Why do you want a Pembroke? |
We want to give him a happy family and being a part of forever family member . Of course we love him because they have great personality and sweet with any people who wanna pet him . I've been researching on internet and on youtuber sites who own the breed . they would show you what should or shouldnt do and how to take care after your first dog get home or where to get the best product for the breed..etc.. | ||||||
Activities planned with Pembroke: |
walking , jogging at the park or beach , hide and seek or watching movie together at home | ||||||
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: |
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Will handle mistakes Pembroke makes like this: |
firmly say stop and show them the right way , praise and treat when they do well | ||||||
Discipline: |
I wouldnt do any , just firmly say STOP and show them the right way | ||||||
Where would Pembroke spend the majority of the time: |
home , park , beach or doing roadtrip with family | ||||||
Discipline: |
I wouldnt do any , just firmly say STOP and show them the right way Where would Pembroke spend the majority of the time: home , park , beach or doing roadtrip with family |
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House dog or outside dog? |
Outside dog | ||||||
People at home during the day? |
yes | ||||||
Where would dog eat? |
dinner room | ||||||
Where would dog sleep: |
living room | ||||||
Play & exercise: |
Jogging in the morning then playing with ball or toy during the day and walking in the evening | ||||||
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: |
apartment with big yard | ||||||
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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
big yard and swimming pool | ||||||
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. | ||||||
May we do a home visit? |
No, I will not 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? |
Me and Nhi Vo | ||||||
Willing to train children? |
I dont have kid | ||||||
Any allergies? |
No one is allergic. | ||||||
Current pets: |
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Current pets dog friendly? |
No, some of our current pets are not 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 | ||||||
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: |