| Date & Referral Source | |||||||
| State: | Date of Application: | 04/18/2018 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years, 3 years – 5 years | Gender preferred: |
Female | Color preferred: |
Red & White, Red Headed Tri, Sable & White | Activity level: |
Couch Potato, Outgoing, Quiet, 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? |
Us | ||||||
Why do you want a Pembroke? |
They are cute. I've meet several they seem friendly. One of the owner I talked to said it was kinda like having a big dog in a small package | ||||||
Activities planned with Pembroke: |
Go for walks, sit on the couch, go for hikes in State Parks. Go out for ice cream. | ||||||
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: |
Deal with it & move on. | ||||||
Discipline: |
like for house breaking, and they pee inside tell them to pee outside… take them outside. Getting them to pee outside would be constantly going outside after meals & saying go potty & putting in their head the picture of them peeing outside
If its a dog fight seperate them & put one in a crate. my dogs have been good or I've been mellow I really haven't had to discipline them. I just dealt with what ever came up in the moment & moved on. I don't hit. If it is required I do raise my voice but not very often. |
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Where would Pembroke spend the majority of the time: |
with me. at home, going for coffee, or a pupachino, maybe some ice cream. no they wouldn't have full cone. Going for a walk, or hikes | ||||||
Discipline: |
like for house breaking, and they pee inside tell them to pee outside… take them outside. Getting them to pee outside would be constantly going outside after meals & saying go potty & putting in their head the picture of them peeing outside
If its a dog fight seperate them & put one in a crate. my dogs have been good or I've been mellow I really haven't had to discipline them. I just dealt with what ever came up in the moment & moved on. I don't hit. If it is required I do raise my voice but not very often. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Sometimes yes & some times no. 60% there, 40% gone maybe | ||||||
Where would dog eat? |
In the kitche | ||||||
Where would dog sleep: |
Where does it want to sleep 2 options is it ok with & like a crate, then a crate, aif it doesn't like that option & is mostly house broke & doesn't eat furniture upstairs next to my bed.
I was raised with a lot of animals, dogs & cat. they always slept in bed with me & I couldn't move. it'n not going to sleep in bed, unless its really manipulative |
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Play & exercise: |
Of course. When I had dogs I walked them everyday about 2 miles. I had 1 golden retriever mix & 2 cocker spaniels. if the corgi can't walk that much I can adjust.
I have a fence yard I can through a ball. |
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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? |
4 foot high wire wielded 1/4 of an acre fenced in | ||||||
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: |
2000 sqr foot house 2 levels.
2 Acer yard 1/4 fenced in |
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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? |
Marj | ||||||
Willing to train children? |
I don't have children. I would work with anyone who came over to the house or anyone who asks questions. | ||||||
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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? |
Yes. | ||||||
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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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