| Date & Referral Source | |||||||
| State: | Date of Application: | 09/02/2018 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
The Dog will have to be ok with being alone for a few hours during the day (we have a dog walker) without destructive behavior. We would like to train her to be a therapy dog. | ||||||
| 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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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? |
We are looking for a dog for the two of us, who we can love and take care of for several years to come. We have a large home and yard, no other pets, and while we don’t have small kids in our home, we have neighbors with young girls who sometimes visit. | ||||||
Why do you want a Pembroke? |
We have done research on the breed and have found the temperament to be compatible with our lifestyle. They are simply adorable and loyal, which we love. They are smart and fun. | ||||||
Activities planned with Pembroke: |
We plan to adopt a dog to be a member of the family, so we will do a lot together, like take walks, snuggle on the sofa, play in the back yard, and visit people. We’re fortunate to have many dog friendly places nearby (shopping/dining). We welcome a protective bark when needed, but we plan to ensure there is discipline as well, as we’ve done with our previous family dogs. |
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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: |
We will employ positive reinforcement training. So we will be clear, firm, but not punitive or emotional. | ||||||
Discipline: |
Again, we use positive reinforcement training. It requires patience, consistency, and establishing that we are in charge. | ||||||
Where would Pembroke spend the majority of the time: |
She will be with us in our home most of the time. We’ll take her on short car trips to places where she’s welcome. We’ll visit friends and family. | ||||||
Discipline: |
Again, we use positive reinforcement training. It requires patience, consistency, and establishing that we are in charge. Where would Pembroke spend the majority of the time: She will be with us in our home most of the time. We’ll take her on short car trips to places where she’s welcome. We’ll visit friends and family. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
We are home for all but about 7 hours on most school days, but we have a reliable, wonderful dog walker who will spend an hour with her during that time. | ||||||
Where would dog eat? |
We have fed previous dogs whatever food is recommended by the vet for their individual needs with great results. | ||||||
Where would dog sleep: |
She’ll sleep in whatever environment she prefers. My previous dog slept in her bed in the on suite master bath, where she could see and smell me while I slept. That enabled me to get a good night’s sleep even though she was only comfortable with having me close. I’m open to other options as well. |
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Play & exercise: |
She’ll get as much exercise and play time as she needs. I will take her out every morning for a walk and play with her, as I have with my previous dog. My daughter will play with her before school as well. Then we have a dog walker who will come a few hours later to play with her and walk her. When my daughter gets home in the afternoon, she’ll take her out in the backyard to play or play inside. She’ll be part of the family, so we’ll have dinner together, do homework with her snuggled nearby, and rub her belly if we watch TV. | ||||||
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? |
We have an invisible fence in the front and back yard. | ||||||
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: |
Large yard with a back patio that has comfy outdoor furniture for snuggling, and lots of grass for rolling and sniffing. There’s a large maple tree that gives us plenty of shade. This neighborhood is filled with dog lovers, so on every walk we take, we meet lots of friendly folks and their dogs, who sometimes like to visit with us. Others are less interested in saying hello, so we give them their space. There is a shallow retention pond behind the back yard that we’ve never had any issues with. But we’ll be diligent to ensure proper leashing/training because a trip in the water would mean an immediate bath, as it’s yucky. |
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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? |
Michele | ||||||
Willing to train children? |
She’s a dog walker, currently caring for a 100 lb lab, a greyhound, and a Pekingese. She’s very educated on how to care for and train dogs. I have owned 5 dogs over my lifetime, and I am willing to continue to learn all I can to ensure a great experience for all of us. |
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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? |
N/a | ||||||
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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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