| Date & Referral Source | |||||||
| State: | Date of Application: | 06/17/2018 | 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 | Gender preferred: |
Female | Color preferred: |
Red Headed Tri, Black Headed Tri | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
Our smooth collie is very relaxed and mellow, but yet fun loving and active. She would love a gentle playmate. Our family would not do well with a hyper or high strung/fearful or anxious dog. | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
|||||||
Dog 1 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is this dog now? |
|||||||
| Dog 2 | |||||||
Dog 2 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is the dog now? |
|||||||
| Dog 3 | |||||||
Dog 3 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
Where is dog now? |
|||||||
| Dog 4 | |||||||
Dog 4 name: |
|||||||
Dog description: |
|||||||
How long owned? |
|||||||
| Where is this dog now? | |||||||
| Questions Regarding Motivation for Adopting and Intentions | |||||||
|
Who is this dog for? |
Our whole family (mom, dad, 6&7yo boys, and 3 yo female smooth collie named Birdie). | ||||||
Why do you want a Pembroke? |
We love hearding breeds, and own a breeder. Corgi's personalities/temperaments/activity levels are very similar to smooth Collies, which we already own and love. Great family dogs with fun and loving personalities-bright and challenging. | ||||||
Activities planned with Pembroke: |
We live in a very large home on over an acre of land. We spend a lot of time outside playing ball, playing "chase" and going for walks in the trails/creeks that surround our home. We also spend a lot of indoor time cuddling, petting, grooming, playing tug and treat mind games. | ||||||
Aware that Pembrokes are busy, noisy dogs? |
Yes | ||||||
|
Money for basic care? |
Yes | ||||||
Money for unforeseen medical expenses? |
Yes | ||||||
Willing to house train? |
Yes Willing to do formal training? Yes |
||||||
|
Do you have a veterinarian? |
Yes | ||||||
Vet contact info: |
|||||||
Will handle mistakes Pembroke makes like this: |
Say no once then move on to positive reinforcement for the desired behavior. Show the doggie what and how you want something done, and reward with treats and praise. | ||||||
Discipline: |
See above. | ||||||
Where would Pembroke spend the majority of the time: |
In our home and outside when she desires. | ||||||
Discipline: |
See above. Where would Pembroke spend the majority of the time: In our home and outside when she desires. |
||||||
|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. | ||||||
Where would dog eat? |
In the designated "doggie dinner" area in the kitchen. | ||||||
Where would dog sleep: |
Upstairs at night; anywhere she would like during the day. | ||||||
Play & exercise: |
I am available for the majority of the day, and we have 2 young boys that also love to play with our girl, Birdie. Birdie will also delight in having a playmate! | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
|
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 an underground fence that has worked brilliantly with our smooth collie. | ||||||
Living arrangements: |
Own home | ||||||
Landlord info: |
|||||||
May we contact your landlord? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
|
Description of yard: |
We live on a 1.15 acre semi-wooded lot. There are vast expanses, hills and shade for the dogs to run, play and rest. no pools or other areas of concern. | ||||||
Household members: |
|||||||
Everyone in household agrees about adopting a corgi? |
Yes, everyone agrees and wants to adopt a Pembroke Welsh Corgi. | ||||||
|
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? |
Elise Larsen | ||||||
Willing to train children? |
Yes. We already have done that when we adopted Birdie Mar when she was 5 months old. | ||||||
|
Any allergies? |
No one is allergic. | ||||||
Current pets: |
|||||||
|
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 | ||||||
|
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. | ||||||
|
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: |
|||||||