| Date & Referral Source | |||||||
| State: | Date of Application: | 12/12/2017 | 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 | 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 | |||||||
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Who is this dog for? |
Both of us | ||||||
Why do you want a Pembroke? |
I have one 2 Welsh Corgis, one for 10 years the other for 15. I love their personalities. Mine were very cute, but at the same time strong willed and lots of personality. Our dogs traveled with us. They were small but study enough to enjoy long walks and were easier to transport and be in our travel trailer than a large dog. I love the breed, but would prefer not to start over with a puppy. | ||||||
Activities planned with Pembroke: |
Walking and companionship would be the main activities. The two I had loved to retrieve which I enjoyed. I might do basic obedience classes if felt it would help us bonf. | ||||||
Aware that Pembrokes are busy, noisy dogs? |
Yes | ||||||
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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: |
Redirect with patience and consistency. | ||||||
Discipline: |
Depends on the situation. Sometimes verbal scolding or just gentle redirecting. | ||||||
Where would Pembroke spend the majority of the time: |
In our home with us. | ||||||
Discipline: |
Depends on the situation. Sometimes verbal scolding or just gentle redirecting. Where would Pembroke spend the majority of the time: In our home with us. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, we are retired. | ||||||
Where would dog eat? |
In the kitchen. | ||||||
Where would dog sleep: |
Hopefully next to our bed. | ||||||
Play & exercise: |
My corgi could exercise just about as much as it wants. We loved playing with our corgi. | ||||||
How will you exercise your dog? |
On leash | ||||||
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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 | ||||||
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Description of yard: |
We do live on a small lake. Our corgi liked to Wade but didn't wish to swim. Besides our spacious yard we own 10 acres across the street. | ||||||
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. | ||||||
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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? |
Ann | ||||||
Willing to train children? |
We don't have children in the home. Depending on the visiting child and the corgi we would teach the child or keep them in separate areas. | ||||||
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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. There will be no additional pets. | ||||||
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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. | ||||||
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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: |
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