| Date & Referral Source | |||||||
| State: | Date of Application: | 06/14/2018 | 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: |
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: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active, Other (Please describe in the box below.) |
Other preferences: |
The dog would be the only one in my condo but I do have family dogs that it would be interacting with on a regular basis. | ||||||
| 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 | ||||||
Why do you want a Pembroke? |
They are very smart dogs that are also social, affectionate and adaptable. I like that they are playful and have unique personalities. I prefer the size of their bread, the general athleticism of the bread and shorter coat. I've had dogs that shed a lot, so that does not bother me. | ||||||
Activities planned with Pembroke: |
Daily walks, trips to the dog beach/park, indoor play with lots of toys, car rides, road trips, visiting family/family dogs, | ||||||
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: |
Give them a stern "no", and use positive reinforcement to ward off the unwanted behavior. | ||||||
Discipline: |
Depending on the behavior I would use a stern voice to distract the dog from the said behavior, would remove toys if being territorial and ignore the unwanted behavior, I would never hit or abuse a dog and do not think banishing them to their crate or giving them a time out if effective in my experience. I'd use positive enforcement to encourage wanted behaviors. | ||||||
Where would Pembroke spend the majority of the time: |
In my condo, with me outside, and/or dog day care | ||||||
Discipline: |
Depending on the behavior I would use a stern voice to distract the dog from the said behavior, would remove toys if being territorial and ignore the unwanted behavior, I would never hit or abuse a dog and do not think banishing them to their crate or giving them a time out if effective in my experience. I'd use positive enforcement to encourage wanted behaviors. Where would Pembroke spend the majority of the time: In my condo, with me outside, and/or dog day care |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I work 8 hours a day, 5 days a week otherwise I am home. I would have someone come to take the dog out or take him/her to dog day care. | ||||||
Where would dog eat? |
In my condo, probably in my kitchen | ||||||
Where would dog sleep: |
They would have their own crate to sleep in if they please but would also have their own bed or could sleep on my bed | ||||||
Play & exercise: |
Daily walks, with a longer walk in the evening. Going to the beach to swim and throw a ball or going to the park. My dog may go to a dog day care where he/she would also get exercise. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
I do not live in a house. | ||||||
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? |
myself | ||||||
Willing to train children? |
I do not have any children | ||||||
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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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