Date & Referral Source | |||||||
State: | Date of Application: | 02/11/2018 | 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: |
3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Quiet, Playful |
Other preferences: |
We have a three year old daughter and are looking for a dog that is good with children.
We are very open to corgi mixes. |
||||||
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? |
Our family. | ||||||
Why do you want a Pembroke? |
Our previous dog was a corgi-sheltie mix and we adored him. He was smart, well-behaved, loyal, funny, gentle, sweet, and so cute. He passed away last summer. While we are still grieving this loss, we are ready to start looking for a new dog. When we started looking at rescue dogs, we realized that how much we liked having a corgi and decided to narrow our focus. | ||||||
Activities planned with Pembroke: |
Go for walks, play in the yard, relax in the house. | ||||||
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: |
Distraction from certain behaviors, short time-outs., positive reinforcement. Obedience training, if necessary. | ||||||
Discipline: |
Having agreed-upon house rules and being consistent with responses (and responding immediately). Distraction from certain behaviors, short time-outs. Establishing hierarchy by eating first, entering the house first, leading on walks, etc. Positive reinforcement–petting, treats, etc. | ||||||
Where would Pembroke spend the majority of the time: |
Inside our house. | ||||||
Discipline: |
Having agreed-upon house rules and being consistent with responses (and responding immediately). Distraction from certain behaviors, short time-outs. Establishing hierarchy by eating first, entering the house first, leading on walks, etc. Positive reinforcement–petting, treats, etc. Where would Pembroke spend the majority of the time: Inside our house. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Lauren works from home 2 days a week and all three family members are home Friday-Sunday. | ||||||
Where would dog eat? |
Our kitchen. | ||||||
Where would dog sleep: |
In our bedroom on a bed, either on the floor or in a crate. | ||||||
Play & exercise: |
We walk regularly spring-fall and occasionally in the winter. We also have a fenced in backyard. | ||||||
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? |
We have a privacy fence on one side of our backyard and a chainlink fence on the other side. | ||||||
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 backyard is completely fenced in. There is a grassy area and a patio. | ||||||
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? |
Lauren and Jeremy | ||||||
Willing to train children? |
Absolutely. Our daughter loves animals and is excited to have a pet again. | ||||||
Any allergies? |
No one is allergic. | ||||||
Current pets: |
|||||||
Current pets dog friendly? |
|||||||
Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
We will not be getting another pet. | ||||||
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: |