| Date & Referral Source | |||||||
| State: | Date of Application: | 03/28/2018 | Referred by: | Breeder | |||
| 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, Playful, Energetic |
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? |
The Pembroke we want to rescue will be for my family and I to have another member who we can love and spend time with since we’re always home. We miss having a furry companion. | ||||||
Why do you want a Pembroke? |
I want to adopt a Pembroke Welsh Corgi because I know they are a very fun and playful breed and having a 4 year old at home who’s an only child, I want him to have someone he can play with and have both of them wear off that energy. I want my son to experience having a dog in his life who is going to be his best friend and after reading about them not getting very big and their personality type, they’d be perfect for our family and my son. | ||||||
Activities planned with Pembroke: |
We have a nice big fenced in yard so we’re constantly outside with my son playing and during the summer we have plenty of BBQs. We have a lake house, so he’d always come with us to go walk on the trails, go to the beach, just relax on our porch which is also fenced in. The Pembroke can walk with me to take my son to school and then we can just hang out at home if the weather isn’t the best. | ||||||
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? |
No | ||||||
Vet contact info: |
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Will handle mistakes Pembroke makes like this: |
Just as you would with a child, calmly remove them from the situation and have them go in a quiet place for a few minutes to relax some of that energy. | ||||||
Discipline: |
The sit command. Distract them and have them look at you and have them sit for a few minutes. Kind of like time out. | ||||||
Where would Pembroke spend the majority of the time: |
In our home, preferably outside of a crate on their dog bed or cuddling with us. Or outside with us on the nicer days. | ||||||
Discipline: |
The sit command. Distract them and have them look at you and have them sit for a few minutes. Kind of like time out. Where would Pembroke spend the majority of the time: In our home, preferably outside of a crate on their dog bed or cuddling with us. Or outside with us on the nicer days. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I work nights and my mother works days because someone needs to always be home with my son because Daycare is too expensive when I have family who is always home. | ||||||
Where would dog eat? |
In our kitchen I’ll have their food and water bowls. | ||||||
Where would dog sleep: |
On their dog bed next to my bed, or in bed with me. | ||||||
Play & exercise: |
Our corgi would have plenty of exercise. Between me walking my son to school and we can walk in the morning, and then when it’s time to walk to pick up my son, and then at night when I get home from work we’ll go for another walk. And then in between we have the big yard with people always walking around and plenty of kids so I know our corgi would have a blast seeing everyone and running around the yard. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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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? |
Chain link about 4-5 feet high. | ||||||
Living arrangements: |
Live with parents in our 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 have an above ground swimming pool, my son has a little playground set with swings and a slide and we have our patio furniture. | ||||||
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? |
Felicia Belcher | ||||||
Willing to train children? |
Yes, I am. Part of the reason for this Pembroke is to help teach my son responsibility. | ||||||
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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, I am. | ||||||
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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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