| Date & Referral Source | |||||||
| State: | Date of Application: | 07/05/2018 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Other (Please describe in the box below.) |
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? |
Me. I have been looking for a dog to adopt/re-home and I found a corgi-Australian shepherd mix I just LOVED but so did many others. I thought I would try your organization to see if you have any corgi's looking for a forever home. I am a very responsible pre-med student with 2 roommates and a boyfriend to help me give lots of love to a four legged friend. I have grown up with dogs all of my life. I am looking for a medium sized dog that would do well in an apartment and is people/dog friendly as I would like to take him/her with me as often as I can. thank you for considering! | ||||||
Why do you want a Pembroke? |
My family has german shepherds and i believe the corgi will have some of the same traits as it is a herding dog. I have never owned one but i believe they have similar characteristics of a big dog in a little dog body which is what i need for apartment living. | ||||||
Activities planned with Pembroke: |
walk, love, play, socialize | ||||||
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: |
re-direct, say no, praise for correct behavior | ||||||
Discipline: |
until the dog knows the rules it is important to watch/monitor them at all times and catch them as they are doing something wrong and say no and praise them for doing the right thing | ||||||
Where would Pembroke spend the majority of the time: |
in my lap:) or on my bed:). If i am not home i would start with a crate until it is safe to leave him/her alone. between my roommates and i it would be less than 6 hours of crate a day. some days none | ||||||
Discipline: |
until the dog knows the rules it is important to watch/monitor them at all times and catch them as they are doing something wrong and say no and praise them for doing the right thing Where would Pembroke spend the majority of the time: in my lap:) or on my bed:). If i am not home i would start with a crate until it is safe to leave him/her alone. between my roommates and i it would be less than 6 hours of crate a day. some days none |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
yes, see above | ||||||
Where would dog eat? |
I would find out what food he/she has been on and continue that most likely otherwise i would choose high qualify food from chuck n don's | ||||||
Where would dog sleep: |
with me unless shows unsafe behavior while i am sleeping then crate until learns safe behavior | ||||||
Play & exercise: |
walking multiple times a day. going to dog parks | ||||||
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: |
Rent/lease home | ||||||
Landlord info: |
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May we contact your landlord? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
Yes | ||||||
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Description of yard: |
n/a | ||||||
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? |
Bria Majeski | ||||||
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? |
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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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