Date & Referral Source | |||||||
State: | Date of Application: | 10/21/2017 | 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: |
3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Quiet |
Other preferences: |
|||||||
Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
|||||||
Dog 1 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is this dog now? |
|||||||
Dog 2 | |||||||
Dog 2 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is the dog now? |
|||||||
Dog 3 | |||||||
Dog 3 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is dog now? |
|||||||
Dog 4 | |||||||
Dog 4 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is this dog now? | |||||||
Questions Regarding Motivation for Adopting and Intentions | |||||||
Who is this dog for? |
My husband and I live in the St. Paul suburb of Maplewood, Minnesota. We have a clean home, no children, and lots of free time outside of work to welcome a Corgi into our lives. | ||||||
Why do you want a Pembroke? |
We love their intelligence and love of being around family, not to mention their short stature! We're both introverted homebodies that want a companion that enjoys walks around our neighborhood and local trails. We are not interested in having children and wish to have a pet to care for and spend time with, as we have plenty of free time outside of our work hours. We have never owned a Corgi, but have done a lot of research on the breed. | ||||||
Activities planned with Pembroke: |
We would take our Pembroke for regular walks around the neighborhood and on local trails. We would get down on the floor and play with him or her, buy plenty of toys, and introduce him to our friends' dogs. He or she would come on road trips to the North Shore with us. We would take our Pembroke to local Corgi meet-ups. Our Pembroke would also spend time with us on the couch watching TV and cuddling. | ||||||
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 |
||||||
Do you have a veterinarian? |
No | ||||||
Vet contact info: |
|||||||
Will handle mistakes Pembroke makes like this: |
Teach the Pembroke better habits, use a stern voice and establish dominance. | ||||||
Discipline: |
Establish dominance, be consistent with how positive behaviors are reinforced and negative behaviors are corrected. | ||||||
Where would Pembroke spend the majority of the time: |
We both work eight hours outside of the home during the week, so our Pembroke would have full run of our house while we're away. When we're home, we'll take him or her for walks. | ||||||
Discipline: |
Establish dominance, be consistent with how positive behaviors are reinforced and negative behaviors are corrected. Where would Pembroke spend the majority of the time: We both work eight hours outside of the home during the week, so our Pembroke would have full run of our house while we're away. When we're home, we'll take him or her for walks. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No. | ||||||
Where would dog eat? |
In our kitchen, next to our dining table. | ||||||
Where would dog sleep: |
Upstairs in our bedroom, near our bed. | ||||||
Play & exercise: |
Our Corgi would go on twice-daily walks during the week, with longer walks in the evenings and on weekends. We will take our Corgi to local dog parks regularly to socialize and play with other dogs. | ||||||
How will you exercise your dog? |
On leash | ||||||
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? |
|||||||
Living arrangements: |
Own home | ||||||
Landlord info: |
|||||||
May we contact your landlord? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
Our townhouse complex has lots of grassy areas for dogs to roam (when leashed). We do not have a swimming pool. | ||||||
Household members: |
|||||||
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? |
Holly and Fernando | ||||||
Willing to train children? |
We do not have children in our home. We do have nephews that visit monthly, and they have dogs in their own home and know how to interact appropriately with animals. | ||||||
Any allergies? |
No one is allergic. | ||||||
Current pets: |
|||||||
Current pets dog friendly? |
|||||||
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: |