| Date & Referral Source | |||||||
| State: | Date of Application: | 04/12/2018 | 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: |
Female, Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Other (Please describe in the box below.) |
Other preferences: |
Two adult cats Prefer a female but will consider a male |
||||||
| 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? |
Darlene & Jon, our family dog | ||||||
Why do you want a Pembroke? |
I grew up with dogs. Jon and I adopted Obie our first Welsh Pembroke Corgi (red & white) in October 1988. Thirteen years later after she passed we adopted Lucy a tri-colored Welsh Pembroke Corgi. We love this breed. They are friendly, fearless, intelligent, travel well, well behaved, like to play, like a walk with a purpose, good around other people, loyal, beautiful, adorable personalities. Our two had very different personalities, but we loved them both. While not hearing impaired, Lucy was excellent for letting me know when the phone was ringing in another room or when visitors were arriving. This was welcomed. | ||||||
Activities planned with Pembroke: |
Take them for daily walks and weekly hikes. Travel with Darlene to her work at church, visiting shut-ins, visiting other churches so must travel well. Long distance car trips to visit family and friends in Canada. On occasion may stay with a friend or in a kennel when travelling. |
||||||
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: |
Tell her "no" and then take her outside or for a walk, when house training. When chewing, say "no" and give her something acceptable to chew. If bored, may be saying she needs attention and/or a walk. |
||||||
Discipline: |
If they won't stop barking then they go outside to calm down or are locked in a bedroom when visitors are present. Also say "no". Give praise when they do something well. I find Corgi's need a reason to do something and praise is not always sufficient. I find small treats help in training and giving praise. |
||||||
Where would Pembroke spend the majority of the time: |
With Darlene at home in St. Joseph or at the church and rectory (church house) in Albion, MI. | ||||||
Discipline: |
If they won't stop barking then they go outside to calm down or are locked in a bedroom when visitors are present. Also say "no". Give praise when they do something well. I find Corgi's need a reason to do something and praise is not always sufficient. I find small treats help in training and giving praise. Where would Pembroke spend the majority of the time: With Darlene at home in St. Joseph or at the church and rectory (church house) in Albion, MI. |
||||||
|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
We both work during the day. Jon is home on weekends. Darlene is home several days during the week. Occasionally our dog must stay home alone, but usually travels with Darlene. | ||||||
Where would dog eat? |
In the bathroom off the laundry room off the kitchen on the main floor. | ||||||
Where would dog sleep: |
Probably in our bedroom. A bed is provided in the living room and Jon's office. | ||||||
Play & exercise: |
Obie loved to chase sticks, tennis balls and Frisbees. Lucy loved to chase small stuffed animals and play tug-a-war. They loved to chase our cats around the house. I like that corgis are small enough to run around the house without knocking things over. We also liked to play tag with Obie and Lucy in the house and backyard. Go for daily walks around the neighborhood. We like to go for extended walks or hikes at least once a week on our days off. |
||||||
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? |
Five foot wooden fence with a secure gate around the whole backyard at St. Joseph. Partial chain link fence at rectory so must be on a chain or supervised at all times. |
||||||
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: |
We live in a two story house with a basement in both. There is a large yard with trees, shrubs, flowers and vegetables in both yards. There are large decks, garages and garden sheds, but no swimming pools. | ||||||
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? |
Darlene | ||||||
Willing to train children? |
No children in our family, but several children at church. A dog needs to be supervised when around others. | ||||||
|
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? |
I don't know if these cats are friendly towards dogs as I adopted them after Lucy died last July. I believe they were around dogs with the previous owners. I will work diligently to integrate new pets into our family. |
||||||
|
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: |
|||||||