| Date & Referral Source | |||||||
| State: | Date of Application: | 04/25/2018 | 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: |
1 year – 3 years, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
We have an 8 year old female Malamute mix, so we want to ensure our next dog would be able to get along with other dogs. | ||||||
| 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? |
Me and my family. | ||||||
Why do you want a Pembroke? |
Our family dog of 15 years, Paco Francis (aka Frank), was a Corgi mix. We loved his personality, how he used to herd our children and their friends when they were young, and what a loyal and protective member of our family he was. Frank was like a baby to me and I miss him so much. It makes me happy when I see dogs that remind me of him. Since he was mostly Corgi, I find myself drawn to other Corgis. I don't care if they are full breeds or mutts. | ||||||
Activities planned with Pembroke: |
Take walks around our neighborhood, snuggle at home together on the couch, go for drives with the window down, go to the beach. | ||||||
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: |
I would try to evaluate what led to him/her making the mistake and address that. If the mistake was the fault of the dog, then I would communicate to him/her that the action was not acceptable. That could be by an assertive verbal command or hand gesture expressing displeasure. If the mistake were something for which there was a right or wrong way to do something, then I would try to redirect the dog to the right way. For example, if the dog wets the rug in the house, I would immediately take him/her outside to the area s/he is supposed to use. | ||||||
Discipline: |
For dogs who can hear, I express my displeasure through my tone of voice. If the dog is on a leash and does something wrong, I pull back on his/her leash. | ||||||
Where would Pembroke spend the majority of the time: |
This would depend on what s/he would enjoy doing. Our dog now loves to be outside so she is on a long lead in the yard for most of the day. When she's not outside, she freely roams around the house. Our other dog preferred to be inside and followed me around from room to room. We do not have off-limits areas inside our house as we consider our dogs to be part of the family so they go where the family goes. | ||||||
Discipline: |
For dogs who can hear, I express my displeasure through my tone of voice. If the dog is on a leash and does something wrong, I pull back on his/her leash. Where would Pembroke spend the majority of the time: This would depend on what s/he would enjoy doing. Our dog now loves to be outside so she is on a long lead in the yard for most of the day. When she's not outside, she freely roams around the house. Our other dog preferred to be inside and followed me around from room to room. We do not have off-limits areas inside our house as we consider our dogs to be part of the family so they go where the family goes. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I am home for most of the day. | ||||||
Where would dog eat? |
In the laundry room. | ||||||
Where would dog sleep: |
On a dog bed in my bedroom. | ||||||
Play & exercise: |
We take our dog(s) for a long walk almost everyday. We have 2 children (age 11 and 13) who love dogs, walk our dog(s), and play with them everyday. | ||||||
How will you exercise your dog? |
On leash | ||||||
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Fenced yard? |
No, I don’t have a fenced in yard. | ||||||
Willing to pick up dog waste? |
Yes, I will clean up after my dog. | ||||||
Willing to use a crate? |
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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: |
We have a large yard that provides both sunny and shady space. We also own a vacant lot adjacent to our yard. We have a large back deck that gets sunny so we are careful about not leave dogs out there when it gets too hot. | ||||||
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? |
Deyar | ||||||
Willing to train children? |
Yes, our children are very empathetic with all animals, especially our own dogs. | ||||||
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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, and we would seek guidance on this. Maya is friendly with other dogs but can demonstrate prey tendencies, as Malamutes often do. But she loves to play with other dogs. | ||||||
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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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