| Date & Referral Source | |||||||
| State: | Date of Application: | 01/27/2018 | Referred by: | Friend | |||
| 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: |
Must be Ok with one grand child visiting 4 times a year. | ||||||
| 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? |
Myself and my husband | ||||||
Why do you want a Pembroke? |
I have owned 3 Pembroke Welsh Corgis previously. Two of them received obedience training with me (one to the CDX level). My daughter trained the third one. My last corgi, "Ginger" lived to age 20. I love their herding instincts, playfulness with fisbees, etc. and their intelligence. They are so loving and enthusiastic. I like that they are fine in snow and my corgis all loved to swim. They are truly a big dog in a smaller body. | ||||||
Activities planned with Pembroke: |
We hike, swim, play frisbee, go to obedience classes and fun matches, visit nursing homes, cuddle, car rides….etc. What don't I like to do with my Corgi? All three of my former Corgis I had from puppy to senior citizen. We've done it all. | ||||||
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: |
Speak the dog's name, say "No" and start again if possible. Of course it depends on the situation. Consistency and firm corrections are important. I do not hit animals etc. Firmness and repeated correction. When done correctly give lots and lots of praise. | ||||||
Discipline: |
I have used a choke collar properly in training situations only. I have occasionally put a dog in their crate if necessary. Verbal firm statements of "no" and positioning them to succeed works too. I try to make training sequential with small steps and lots of praise. I take them to Twin Ports Dog training classes for socialization and sequential learning around other dogs. | ||||||
Where would Pembroke spend the majority of the time: |
In our home and 5 acres of woods and gardens. We want only inside dogs with a fenced yard if needed. We have recently moved to our retirement home that is like a park with no close by neighbors. There is plenty of room for playing and long walks. | ||||||
Discipline: |
I have used a choke collar properly in training situations only. I have occasionally put a dog in their crate if necessary. Verbal firm statements of "no" and positioning them to succeed works too. I try to make training sequential with small steps and lots of praise. I take them to Twin Ports Dog training classes for socialization and sequential learning around other dogs. Where would Pembroke spend the majority of the time: In our home and 5 acres of woods and gardens. We want only inside dogs with a fenced yard if needed. We have recently moved to our retirement home that is like a park with no close by neighbors. There is plenty of room for playing and long walks. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, we are both retired now. I like to do art and have a studio in my home. My husband likes to garden. We like to walk by Lake Superior. We are home most of the time. We don't like to travel much. | ||||||
Where would dog eat? |
In the kitchen in their designated location We have warm ceramic floors and it is not a problem to clean up. | ||||||
Where would dog sleep: |
In our bedroom on a dog bed. We don't usually have them in the bed with us. They usually sleep right next to the bed. | ||||||
Play & exercise: |
Everyday we play and walk with our dog. We have trails in the woods to walk and on the beach by Lake Superior. My other corgis loved frisbees and this gave them plenty of running exercise. Sometimes we walk with friends and their dogs. We are very active seniors. We take our dog everywhere. They love going on our pontoon boat. It is so much fun. Obedience training keeps their attention and interest also. | ||||||
How will you exercise your dog? |
On leash | ||||||
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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 large area so it doesn't really feel very fenced in. It is posts with large wire blocks. It is safe and cannot cause harm to the dog. We have two gates. We may make a new fence depending on the dog we get. It is about 5 feet high and embedded in the earth. It works well. | ||||||
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: |
Big open spaces with large maple, birch, trees. Rock gardens of flowers and a vegetable garden. A small pond with water lillies. The yard is surrounded by forest with huge white pines, etc. It is beautiful. The pond is shallow and doesn't pose a problem with fence able to be in closer than the pond. We have a patio, etc. | ||||||
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? |
Lorraine Norrgard | ||||||
Willing to train children? |
Absolutely yes. My only grandchild will learn how to be kind and respectful of all animals. | ||||||
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Any allergies? |
No one is allergic. | ||||||
Current pets: |
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Current pets dog friendly? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
Yes. We do not want more than one dog or other animal in the house. Once we had a parakeet with our corgi, but that is all. I am allergic to cats…only cats. We had a horse a long time ago for our daughter. No other pets. We can resolve any issues. | ||||||
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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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