| Date & Referral Source | |||||||
| State: | Date of Application: | 03/28/2018 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Playful |
Other preferences: |
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| Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
This would be a dog for me. I live alone and need a companion to go out and do activities with and hang out and take care of. | ||||||
Why do you want a Pembroke? |
I think they are the cutest dogs. I love there short little bodies, and they seem to be very energetic which i want in a dog. My only experiences have been running into people with them and interacting through that. Also my next door neighbor has one so i have played with him a couple times. (Perfect play date opportunity) | ||||||
Activities planned with Pembroke: |
There is a dog park right by where i live, so going and playing there. Also going on walks with me as i walk the trail almost every day. | ||||||
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: |
I would not be aggressive, but stern in letting him know that it is not ok and that i am in charge and the rules have to be followed. | ||||||
Discipline: |
Just being stern and letting them know i am in charge. No smacking. | ||||||
Where would Pembroke spend the majority of the time: |
They would spend most of the time wherever i am. We have a open dog policy where i work so i would probably bring them with me when they are properly trained. | ||||||
Discipline: |
Just being stern and letting them know i am in charge. No smacking. Where would Pembroke spend the majority of the time: They would spend most of the time wherever i am. We have a open dog policy where i work so i would probably bring them with me when they are properly trained. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No but would be coming to work with me | ||||||
Where would dog eat? |
In the house. Where the food and water dish is. Probably near the kitchen area | ||||||
Where would dog sleep: |
With me or on a bed in my room. | ||||||
Play & exercise: |
Everyday! I do my exercise and want a pal to do so with. | ||||||
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? |
Wooden fence that surrounds the whole backyard and has latching fence doors. | ||||||
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: |
Don't know exact dimension but is plenty big for a pet and has fencing. No open fixtures just grass. | ||||||
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? |
Ashton Williamson | ||||||
Willing to train children? |
I dont have children but yes,. | ||||||
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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? |
Have no 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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