| Date & Referral Source | |||||||
| State: | Date of Application: | 05/14/2018 | Referred by: | Other | |||
| 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: |
Couch Potato, 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? |
Myself primarily, but it will be in a home with 4 adults, and other friendly dogs. | ||||||
Why do you want a Pembroke? |
I want to adopt a Pembroke Welsh Corgi for several reasons. The first reason is because as a child, my grandparents had one, named Colby, and he made a lasting impact on my life. I went to puppy school with the corgi, I helped teach him tricks, and I grew up understand the temperament of the breed, so I feel confident that I know how to handle the breed at any age. I also want to adopt a PWCorgi because it has been my dream for ever. I have done research on all things corgi, and it is my lifelong goal to eventually have one to love and give the best life ever. | ||||||
Activities planned with Pembroke: |
I would take my Pembroke on walks, as we live right by a bicycle railtrail that allows dogs. I would also like to take it to dog parks near me, and the corgi meet ups that happen towards the southern part of Michigan, so that the Pembroke could be around other dogs like itself. I would do anything and everything with my corgi. | ||||||
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 correct the mistake with a firm no. I also have used a spray bottle in the past with other dogs, if the firm tone doesn't seem effective. I would also correct mistakes by turning away from the dog to dis-engage and teach them that that behavior does not reap attention. | ||||||
Discipline: |
Spray bottle, and using a kennel for a time out. | ||||||
Where would Pembroke spend the majority of the time: |
My Pembroke would spend most of their time indoors in the house where the family and other dogs are. | ||||||
Discipline: |
Spray bottle, and using a kennel for a time out. Where would Pembroke spend the majority of the time: My Pembroke would spend most of their time indoors in the house where the family and other dogs are. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes | ||||||
Where would dog eat? |
My corgi would eat indoors, probably set up in the kitchen. | ||||||
Where would dog sleep: |
My corgi would sleep with me in my room, hopefully on my bed. | ||||||
Play & exercise: |
I will provide opportunities to play and exercise by taking them on walks and to parks, as well as having doggy dates with other pets I know. The corgi would receive adequate exercise and play daily, at least an hour of dedicated time. | ||||||
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? |
My fence goes around the inner backyard, it is a metal fence, with a locking gate, and there are no holes or weak spots where it could escape. | ||||||
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: |
The yard has a small firepit, a hot tub that always has the cover on it, and a deck. The yard is fenced in and has bushes, flowers, grass, and a few trees. | ||||||
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? |
Sierra | ||||||
Willing to train children? |
I do not have any children, or children in the home. | ||||||
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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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