Date & Referral Source | |||||||
State: | Date of Application: | 11/06/2017 | 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: |
Female | Color preferred: |
Any color | Activity level: |
Playful, Energetic, Very Active |
Other preferences: |
I would need a dog that is socially competent with other dogs. Or one that could be corrected with training. | ||||||
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 | |||||||
Who is this dog for? |
The dog would be for my family. I currently have a four year old female German Shepard. I love herding dogs and thought a Corgi would be a great addition to my family. I have a great fenced in yard and my dogs have all had beautiful loved filled lives full of adventure and fun! | ||||||
Why do you want a Pembroke? |
I like their attention, playfulness and work ethic. I have known several in my life and currently would like a smaller dog. | ||||||
Activities planned with Pembroke: |
Lots of walks, playing at the beach, swimming and playing with other dogs. | ||||||
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: |
An appropriate verbal correction. | ||||||
Discipline: |
verbal and if on leash the appropriate correction. | ||||||
Where would Pembroke spend the majority of the time: |
At home and summers on the lake in Michigan. | ||||||
Discipline: |
verbal and if on leash the appropriate correction. Where would Pembroke spend the majority of the time: At home and summers on the lake in Michigan. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, My wife. | ||||||
Where would dog eat? |
In the kitchen. | ||||||
Where would dog sleep: |
Anywhere she wants | ||||||
Play & exercise: |
My German Shepard currently gets 2-3 walks a day. One with a dog walker and a mixture of other dogs 4 days a week (the days when I am working). the other two walks with my stay at home wife in the AM and the two of us at night. My three day weekends are always with my dogs. They do "everything" with me! |
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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? |
4 ft metal. very secure. | ||||||
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 | ||||||
Description of yard: |
Decent sized yard with a dog run just for early AM and Pre bed time duty. We also spend a lot of time in michigan at family cottages where the dogs are safe to run and swim. |
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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? |
Split between my wife and I | ||||||
Willing to train children? |
My Children are excellent pet owners and handlers. | ||||||
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? |
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: |