| Date & Referral Source | |||||||
| State: | Date of Application: | 05/02/2018 | 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
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 pembroke would be for my husband and I. We are newlyweds and are looking to get our first family dog. | ||||||
Why do you want a Pembroke? |
Growing up I have always wanted to adopt a corgi. At first I was attracted to the size of the dog. I have always wanted a medium size dog. After doing a lot of research on the dog I love that the corgi is a perfect companion. They always want to be near their loved ones and are very curious energetic creatures. I love that they enjoy routine and really become aware of your habits. A family friend of ours has two pembrokes and we have interacted with their dogs quite a bit. | ||||||
Activities planned with Pembroke: |
I would love to take the dog on daily walks. We also have a large backyard for the dog to run around in and play fetch in. | ||||||
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 remain calm if the dog made a mistake. I would try to see if there is also maybe something I am doing wrong that the dog is causing trouble. say for instance if the dog is getting into things around the house… is it bored? Do we need to go outside and play? | ||||||
Discipline: |
I would raise my voice. I would want the dog to know that he did something wrong but I would never resort to any physical ways to discipline a dog. | ||||||
Where would Pembroke spend the majority of the time: |
Most of the time we would like our pembroke to spend with us. We would like this dog to be part of our daily lives. | ||||||
Discipline: |
I would raise my voice. I would want the dog to know that he did something wrong but I would never resort to any physical ways to discipline a dog. Where would Pembroke spend the majority of the time: Most of the time we would like our pembroke to spend with us. We would like this dog to be part of our daily lives. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
During the summer months someone would be home daily with the dog as my husband is off during the summers. We also have close friends that have a dog walking business that could drop by during the day if we were not home to let dog out/feed him or her. | ||||||
Where would dog eat? |
We have an area in our kitchen where the dog could eat/ have his or her water bowl out. | ||||||
Where would dog sleep: |
We would provide a dog bed for the dog and a crate. We know that crates are comforting to dogs so we would also allow him/her to sleep in it. | ||||||
Play & exercise: |
We would do a lot of play/exercise time in our backyard. It is fully fenced so we could have him or her go out without a leash and be able to run freely. We will also take him or her for walks. | ||||||
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? |
We have a wooden fence that fully encloses our yard. | ||||||
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 big back yard. The only fixture we have is a garden bed. | ||||||
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? |
my husband and I | ||||||
Willing to train children? |
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? |
no other 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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