| Date & Referral Source | |||||||
| State: | Date of Application: | 08/07/2018 | 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: |
Couch Potato, Outgoing, Quiet, Playful |
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? |
me | ||||||
Why do you want a Pembroke? |
I've always enjoyed the breed. I've owned other dog breeds, not a Corgi. I admire their intelligence, their athleticism, the working breed nature. | ||||||
Activities planned with Pembroke: |
walks, agility courses, weekend adventures, goofing off in the yard. | ||||||
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: |
Determine what commands the dog understands. Ensure the dog knows what No means and enforce that the mistake is a 'No' verbally. I need to be firm with the dog and reward good behavior. Always be friendly, never mean, no physical treatment. | ||||||
Discipline: |
Again, the trainer/owner needs to be firm but friendly with the dog. Show them right from wrong based on events that occur. Reward them with a treat when one can but not all the time. A 'good boy, good girl' can be reward enough along with additional activity, brushing, stroking, etc. | ||||||
Where would Pembroke spend the majority of the time: |
I work during the day so the dog would be inside. Once home, we would be in and out of the home. | ||||||
Discipline: |
Again, the trainer/owner needs to be firm but friendly with the dog. Show them right from wrong based on events that occur. Reward them with a treat when one can but not all the time. A 'good boy, good girl' can be reward enough along with additional activity, brushing, stroking, etc. Where would Pembroke spend the majority of the time: I work during the day so the dog would be inside. Once home, we would be in and out of the home. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
normally no. | ||||||
Where would dog eat? |
in the house | ||||||
Where would dog sleep: |
in my bedroom | ||||||
Play & exercise: |
the Corgi would get exercise and play time each day but it would come early in the morning and at night. | ||||||
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: |
1/3 acre lot. back yard could easily be fenced in with 65 feet of fencing. front yard is open. No pools, ponds, | ||||||
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? |
Carl Juckett | ||||||
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? |
no other pets so 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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