Date & Referral Source | |||||||
State: | Date of Application: | 12/05/2017 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
We already have one delightful corgi daughter in our home and we're looking to find her a great sibling! | ||||||
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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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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Questions Regarding Motivation for Adopting and Intentions | |||||||
Who is this dog for? |
Myself and my husband. | ||||||
Why do you want a Pembroke? |
My husband grew up with corgis and absolutely loved them. 2 years ago we adopted our first child, little Dax (who is a Pembroke Welsh Corgi), and so much joy has been brought to our lives! We absolutely love the Corgi sense of playfulness and companionship. | ||||||
Activities planned with Pembroke: |
Our 2nd fur baby would be a house pet and get tons of love from her sister and the two of us. We love to go on car rides and walks in the park. It's also rare to not see a great game of fetch played several times a day in our home. | ||||||
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: |
We can't imagine that it would be, but if there was an unforseen circumstance, we would make sure it was adopted by the most loving of families. | ||||||
Discipline: |
We use verbal commands at first to stop an undesired behavior. If the verbal commands do not seem effective, we use a water squirt bottle. For positive behavior, petting and treats are given. | ||||||
Where would Pembroke spend the majority of the time: |
Inside our house in Brazil, Indiana | ||||||
Discipline: |
We use verbal commands at first to stop an undesired behavior. If the verbal commands do not seem effective, we use a water squirt bottle. For positive behavior, petting and treats are given. Where would Pembroke spend the majority of the time: Inside our house in Brazil, Indiana |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes | ||||||
Where would dog eat? |
At her own bowl in our bedroom | ||||||
Where would dog sleep: |
In its own bed or our bed, whichever it prefers | ||||||
Play & exercise: |
We will play fetch daily and get to the park a few times a week in good weather. We will make sure it gets all the play and exercise it needs to stay healthy and happy. | ||||||
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 is a wire fence. | ||||||
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: |
It is a flat yard with a wire fence. | ||||||
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? |
Ashlee Vitz | ||||||
Willing to train children? |
Absolutely | ||||||
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? |
Absolutely | ||||||
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: |