Date & Referral Source | |||||||
State: | Date of Application: | 12/02/2017 | 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: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Energetic |
Other preferences: |
We do have another dog, Teddy, who is a husky mix we adopted when he was 8 months old. He is now 10 years old and very sweet and social and would do well with another dog. | ||||||
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? |
To be part of our family…..my daughter rides horses and we have been around many Corgis and fallen in love with them. My daughter, Halsey, is 13 years old and is very excited and ready for a Corgi in our life. | ||||||
Why do you want a Pembroke? |
We want to adopt because the Pembroke Welsh Corgi is a very family friendly dog that enjoys activity and is intelligent to train and become part of our everyday lives. And they are very cute too:) | ||||||
Activities planned with Pembroke: |
We would have daily walks and do training classes if needed. We would bring them to our local horse shows to spend the day with us as my daughter competes in her shows. | ||||||
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? |
Yes | ||||||
Vet contact info: |
|||||||
Will handle mistakes Pembroke makes like this: |
If we found the mistake as they were doing it then tell them no firmly and put them in a crate for 5 minutes. I believe that we are responsible to know when they are ready to be left in house alone, etc. and that it needs to be tested slow and steady gradually increasing time. | ||||||
Discipline: |
We would use firm words and crate training if needed. Because of working out of my home I am around and flexible to be here throughout the day which assists in teaching them and being here to observe behavior. | ||||||
Where would Pembroke spend the majority of the time: |
With our family in our home or going for walks in our neighborhood. | ||||||
Discipline: |
We would use firm words and crate training if needed. Because of working out of my home I am around and flexible to be here throughout the day which assists in teaching them and being here to observe behavior. Where would Pembroke spend the majority of the time: With our family in our home or going for walks in our neighborhood. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I work from my home and am around and flexible throughout the day. Myself and my children are around after 4pm and my husband is home after 7pm at night. | ||||||
Where would dog eat? |
As we have another dog we would need to figure out the best option for their eating habits but currently our dog has food/water bowls in our kitchen so we could do the same or if needed to separate we certainly could adapt to that as well. | ||||||
Where would dog sleep: |
Would sleep in our daughters room……she would love to have in her bed with her but also would have a dog bed on floor if that was preferable. | ||||||
Play & exercise: |
Daily walks for sure and my daughter would give 100% attention when she was home. Also with our other dog I'm sure they would play together as well. | ||||||
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? |
6 foot fence in the back yard.
Invisible fence in the front yard. |
||||||
Living arrangements: |
Own home | ||||||
Landlord info: |
|||||||
May we contact your landlord? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
Our yard is fenced in the back with grass and the fence allows access to driveway as well. We do not have any swimming pools, hot tubs, or anything or that nature. We have a wonderful park that I currently walk our dog to every day. | ||||||
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? |
My daughter Halsey and then me while she is at school | ||||||
Willing to train children? |
Yes I believe that we have done that as parents. We owned our first dog prior to children and we have always had a dog in our family. | ||||||
Any allergies? |
No one is allergic. | ||||||
Current pets: |
|||||||
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: |