| Date & Referral Source | |||||||
| State: | Date of Application: | 09/01/2018 | Referred by: | Website | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
| Address | |||||||
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| City: | State: | Zip: | |||||
| Type of Dog Wanted | |||||||
Ages interested in: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Red & White, Red Headed Tri, Sable & White | Activity level: |
Other (Please describe in the box below.) |
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? |
My husband Dan and I | ||||||
Why do you want a Pembroke? |
In our 31 years of marriage, we have owned a long-haired dachshund that lived for 16 1/2 years, shortly after him we rescued a Red-tick cattle healer mixed with a Beagle he was 6 months old. He was very sick when we got him and he had seizures for most of his life (which we medicated for) until he passed away at 13 in May 2018. In my research on the Corgi breed, I appreciate the easy-going personality, trainablity and small-dog size, which is what would be a good fit for us. | ||||||
Activities planned with Pembroke: |
Walk daily as we are active. We also own a boat, and would like to take the dog with us boating (the boat has a shade area for the dog and myself, :). My husband and I like to spend a lot of time outdoors, which I think a dog would like as well. We are interested in getting a dog to spend time with. We also have friends with dogs and kids that are well socialized so we would socialize our new dog. Our dogs become our fur-babies, they are family. We are also considering purchasing a camper so we can take our dog with us on vacations. | ||||||
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? |
Yes | ||||||
Vet contact info: |
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Will handle mistakes Pembroke makes like this: |
If catching the dog making a mistake in the act, I would calmly walk over and firmly say "No" and then immediately either pick him up and take the dog outside or to the paper, and then when the dog continues in the right spot, I would praise him which constitutes an acceptable behavior. If unable to catch in the act, then I just clean up the mess because he won't understand the correction at that point. Continually praising good behavior is the most effective training. | ||||||
Discipline: |
Calmly saying "No" and then teaching them to sit (this sometimes works as a distraction from the behavior they were exhibiting). Also, stop playing with them or turn your back for a bit. Also, letting them outside for a mini time out break. And always praising good behavior. | ||||||
Where would Pembroke spend the majority of the time: |
Either inside our home or if we are outside, with us in whatever we are doing. | ||||||
Discipline: |
Calmly saying "No" and then teaching them to sit (this sometimes works as a distraction from the behavior they were exhibiting). Also, stop playing with them or turn your back for a bit. Also, letting them outside for a mini time out break. And always praising good behavior. Where would Pembroke spend the majority of the time: Either inside our home or if we are outside, with us in whatever we are doing. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I only work 7 hours a day/4 days a week and I live 20 minutes from work. | ||||||
Where would dog eat? |
In the kitchen | ||||||
Where would dog sleep: |
In his/her bed in either our bedroom or the kitchen | ||||||
Play & exercise: |
We have friends with dogs that we get together with regularly. My husband and I walk daily. | ||||||
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: |
We live on 1 acre of property. No pool. Backed into woods. We have an invisible dog fence from our previous dog that we will train our next dog using flags and leash training, following the invisible fence training video instructions. | ||||||
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? |
Kellie Ryan | ||||||
Willing to train children? |
Our children are grown and moved out, however we anticipate grandchildren in the next couple of years. And yes, we would teach how to be respectful to our fur-baby. | ||||||
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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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