| Date & Referral Source | |||||||
| State: | Date of Application: | 09/13/2018 | Referred by: | Friend | |||
| 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
Good with other dogs and good with kids. | ||||||
| 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 significant other. | ||||||
Why do you want a Pembroke? |
My brother has a wonderful Corgi, named Bucky. When he adopted Bucky, my whole family fell in love with the breed. He is actually now a certified therapy dog that goes to nursing homes and hospitals. He is energetic, fun-loving, and a dorky dog. I have learned a lot about the breed through further research and through my experiences with my brother and Bucky. If I were to get any breed of dog, corgis are at the top of my list. | ||||||
Activities planned with Pembroke: |
We would go on nice short walks and lounge around the house. I plan to have him/her travel with us to visit friends and family. I would love to him/her to dog parks. If the personality is fit for therapy dog life, I would love to train and certify the dog to give back to the community. As a nurse, I have seen the wonderful impact that dog therapy has for patients and myself. | ||||||
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: |
I would not yell at the dog, because that makes them anxious and confused. For example, if the couch is torn up, there is not much we can do – its already torn up and yelling at the dog is going to make them upset, anxious, and confused. Instead, I would refocus the dog away from the mistake and praise them when they perform good deeds to help the dog understand good behavior. | ||||||
Discipline: |
Main thing is to not confuse the dog with praise for bad behavior. Refocusing the dog is key. | ||||||
Where would Pembroke spend the majority of the time: |
Most of the time the dog would be with us inside or outside. If we are out and about without the dog, we plan to have the dog be able to roam about in the living space. | ||||||
Discipline: |
Main thing is to not confuse the dog with praise for bad behavior. Refocusing the dog is key. Where would Pembroke spend the majority of the time: Most of the time the dog would be with us inside or outside. If we are out and about without the dog, we plan to have the dog be able to roam about in the living space. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. | ||||||
Where would dog eat? |
We have an open concept living space. We plan to have the bowls near the kitchen. | ||||||
Where would dog sleep: |
We plan to have a dog bed in the bedroom, but we would like to see how the dog interacts and figure out where the dog would be comfortable. I know dogs that find comfort in their kennel if that is what they are used to, or they might like a dog bed. So this we would have to play by ear. | ||||||
Play & exercise: |
There are a lot a nice trails and dog parks in the area. We would take the dog outside frequently throughout the day. I would love for the dog to play with other dogs by meeting up with our family and friends' dogs, as well as dogs at the dog parks. | ||||||
How will you exercise your dog? |
On leash | ||||||
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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: |
Rent/lease home | ||||||
Landlord info: |
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May we contact your landlord? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
N/A | ||||||
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? |
Anna and Sayee | ||||||
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? |
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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