Date & Referral Source | |||||||
State: | Date of Application: | 12/07/2017 | 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: |
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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? |
Our family | ||||||
Why do you want a Pembroke? |
My daughter (17 years old) and son (15 years old) have done extensive research on the breed and have shared the information with me. I have also done research and have met several Corgis. We believe that a Corgi will fit in very well with our family. Specifically, we are an active family that enjoys having a furry family member accompany us on our walks and hikes. We live in a home that can easily accommodate another dog with several acres for the dog to play. Our current dog, Maize, is very friendly and loves socializing with other dogs. The intelligence of the Corgi is very appealing to me as a well-trained dog is crucial. We will invest our time, money and love into a Corgi just as we have with Maize. | ||||||
Activities planned with Pembroke: |
Walk Run Play ball Swim Snuggle |
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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: |
Depending upon the mistake I would use either verbal scolding or a crated time out. | ||||||
Discipline: |
Verbal scolding Crated time out Occasional spray with water I prefer using positive reinforcement and training to minimize the need for discipline. |
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Where would Pembroke spend the majority of the time: |
Throughout our home | ||||||
Discipline: |
Verbal scolding Crated time out Occasional spray with water I prefer using positive reinforcement and training to minimize the need for discipline. Where would Pembroke spend the majority of the time: Throughout our home |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes | ||||||
Where would dog eat? |
In the family entry area off the garage | ||||||
Where would dog sleep: |
In my bedroom | ||||||
Play & exercise: |
Frequent walks Play with Maize Play with all family members |
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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: |
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: |
Our home is on several acres with a wooded area as well as open field. It sits 1/4 mile away from the road. | ||||||
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? |
Carrie | ||||||
Willing to train children? |
Yes | ||||||
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: |