| Date & Referral Source | |||||||
| State: | Date of Application: | 08/08/2018 | 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: |
3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Quiet, Playful |
Other preferences: |
We have a cat, also have visitors who have young children and other dogs. So we need a dog who will be comfortable around all other animals and children. | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
Dog 1 |
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Dog 1 name: |
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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? |
Josh and Kali as we live together | ||||||
Why do you want a Pembroke? |
Kali and I have been very big fans I’d the breed. We really like the aesthetic, temperament, and size of the breed. We have both had experiences with corgis through mutual friends. We have done some basic research on their general health issues and temperament. | ||||||
Activities planned with Pembroke: |
Take them to the nearby park, walk them, bring them to play dates with other dogs our friends have, and of course plenty of cuddles on the couch, | ||||||
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: |
Verbally reprimanding them, followed up by a time out in their crate with varying levels of time in the crate depending on what they do. | ||||||
Discipline: |
Verbally reprimanded, time outs. | ||||||
Where would Pembroke spend the majority of the time: |
In our apartment | ||||||
Discipline: |
Verbally reprimanded, time outs. Where would Pembroke spend the majority of the time: In our apartment |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Ye we both work and I go to school, but our schedule doesn’t overlap much so someone is usually home for much of the day. | ||||||
Where would dog eat? |
In our home, | ||||||
Where would dog sleep: |
We would buy them a dog bed or they could sleep in bed with us. | ||||||
Play & exercise: |
We have a dog park for our apartment, also a city park nearby. We will provide plenty of walks and trips to the park. We see exercise as a vital part of caring for a dog. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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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? |
Chain link fence for the dog park for our apartment, | ||||||
Living arrangements: |
Rent apartment | ||||||
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: |
We don’t 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? |
Kali and josh with equal responsibility | ||||||
Willing to train children? |
We don’t have any children, but will be sure to talk to children who will visit about how to treat our corgi, | ||||||
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Any allergies? |
One or more family members might be allergic to dogs. | ||||||
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? |
We prefer s corgi that is already good with pets and other animals, We will not bring home a dog who won’t get along with our current pet. | ||||||
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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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