Date & Referral Source | |||||||
State: | Date of Application: | 10/11/2017 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years, 3 years – 5 years | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Energetic |
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? |
Max Moss | ||||||
Why do you want a Pembroke? |
They are small dogs with big personalities. A good friend of mine had a corgi and he was just the most friendly dog I knew and the pup and I were pretty close. I have researched online about corgis: what activity level they need, what they eat, good toys for them, etc. | ||||||
Activities planned with Pembroke: |
I live right by the beach off the lake so walking up and down that during the summer would be a big one. In the winter we would probably stay a little closer to home but if he's down to walk, so am I. I have a courtyard that we can play catch in. | ||||||
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: |
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Will handle mistakes Pembroke makes like this: |
If by mistake it's meant going potty in the house, I will show him the accident and sternly say "no". The same when chewing on stuff he shouldn't be. | ||||||
Discipline: |
Sternly saying "bad dog" or "no." If that doesn't work, I've seen squirt bottles be useful in some situations. | ||||||
Where would Pembroke spend the majority of the time: |
My apartment. | ||||||
Discipline: |
Sternly saying "bad dog" or "no." If that doesn't work, I've seen squirt bottles be useful in some situations. Where would Pembroke spend the majority of the time: My apartment. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No | ||||||
Where would dog eat? |
In our kitchen most likely | ||||||
Where would dog sleep: |
At first I would crate him, but then once he's more comfortable he would probably sleep in my room. I would get him his own bed. | ||||||
Play & exercise: |
I have the courtyard to do shorter more playful exercising (catch and running around) and walks around the neighborhood for longer exercise, at least once a day. On the weekends I plan on taking for longer walks. | ||||||
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? |
It's more of a courtyard, but it's very well blocked off and my old roommate used to run her dog around in there. There's shrubbery and non-paved areas. | ||||||
Living arrangements: |
Rent/lease home | ||||||
Landlord info: |
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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? |
Not applicable | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
N/a | ||||||
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? |
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? |
Max Moss | ||||||
Willing to train children? |
No children | ||||||
Any allergies? |
No one is allergic. | ||||||
Current pets: |
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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? |
No current 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: |