| Date & Referral Source | |||||||
| State: | Date of Application: | 08/04/2018 | 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: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Very Active |
Other preferences: |
Any Corgi that has a loving personality, someone that can be somewhat of an emotional support from time to time. | ||||||
| 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 and my fiance' | ||||||
Why do you want a Pembroke? |
My fiance' Kellie loves Corgis in particaular because of their cute stubby legs, and they are for the most part a naturally playful breed. They are also very loving, which is the main thing she needs. | ||||||
Activities planned with Pembroke: |
Walk, go to the dog park, go to the beach, take car rides/trips with, Play fetch, snuggle. | ||||||
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: |
Give a firm "no", but not too harsh, as to not make the dog scared/fearful. If for example, he/she makes a mess in the house, look at him with a little disappointment, and give a firm, but gentle, "No" as you look at him/her, and then take him/her outside to help him learn from his/her mistakes. | ||||||
Discipline: |
Spray bottles could be used in some situations, with a very light mist, but I guess it would depend on the breed and temperament of the dog. My previous asnwer of using a firm but gentle "no" could work, or you could use the "sit" command as a distraction from the "bad" thing he/she is doing. But again, I guess it really depends, each dog is different. | ||||||
Where would Pembroke spend the majority of the time: |
Probably outside in the yard running/ playing. | ||||||
Discipline: |
Spray bottles could be used in some situations, with a very light mist, but I guess it would depend on the breed and temperament of the dog. My previous asnwer of using a firm but gentle "no" could work, or you could use the "sit" command as a distraction from the "bad" thing he/she is doing. But again, I guess it really depends, each dog is different. Where would Pembroke spend the majority of the time: Probably outside in the yard running/ playing. |
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House dog or outside dog? |
Outside dog | ||||||
People at home during the day? |
Yes, usually there is someone home for some/most of the day. The longest anyone would be gone at any given time may be 3 or 4 hours. | ||||||
Where would dog eat? |
There would probably be a set place in the house that is away from the dinner table so he/she doesn't beg/expect food when we sit down to eat (personal preference) | ||||||
Where would dog sleep: |
Wherever he or she feels comfortable to sleep. On the couch, in the bed, or I would invest in a nice padded dog bed. | ||||||
Play & exercise: |
I go out frequently to parks/the beach, and if a companion would join us, in the future, definitely a not so crowded dog park (at first) | ||||||
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? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
There is a large field behind the house with a couple of trees. Other than that, it is a wide open back yard. | ||||||
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? |
Kelly Behrens | ||||||
Willing to train children? |
N/A | ||||||
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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, of course. It's a learning process, it will take patience (alot of it!) | ||||||
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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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