Date & Referral Source | |||||||
State: | Date of Application: | 11/02/2017 | Referred by: | Other | |||
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 | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
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? |
Mostly for Victoria as a companion. We do not currently have children, but plan to have them in 2-3yrs. | ||||||
Why do you want a Pembroke? |
the research I've done on the breed suggested that they adapt well to apartment living. as much as I'd like to have an energetic large size dog, our apartment won't accommodate them. our neighbors have a corgi that they love and I think our lifestyle will be a good fit for one as well. | ||||||
Activities planned with Pembroke: |
we have a nice dog park in our neighborhood. We also spend a lot of time with extended family, there are plenty of nieces and nephews and other dogs to play with. | ||||||
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: |
show correct action, then praise for correct action. | ||||||
Discipline: |
a firm "no" and maybe a timeout in his crate, f the situation permits. | ||||||
Where would Pembroke spend the majority of the time: |
With us in our apartment, and anywhere that will allow him to come with us. | ||||||
Discipline: |
a firm "no" and maybe a timeout in his crate, f the situation permits. Where would Pembroke spend the majority of the time: With us in our apartment, and anywhere that will allow him to come with us. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
My husband and I have pretty solid schedules. I go to school part-time and work parttime, so luckily I get a lot of time at home. Starting in December my husband will be working full time on a fairly regular schedule. The dog wouldn't be alone for any more than 6hrs. | ||||||
Where would dog eat? |
In the kitchen, where his food bowls are. | ||||||
Where would dog sleep: |
In a crate in our bedroom. | ||||||
Play & exercise: |
I am a firm believer in squeaky toys! There are plenty of other puzzle toys for us to get him as well, or one of those battery operated balls that rolls on its own. | ||||||
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 | ||||||
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? |
Yes | ||||||
Description of yard: |
Dog park | ||||||
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? |
Victoria | ||||||
Willing to train children? |
Absolutely | ||||||
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? |
N/A | ||||||
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: |