| Date & Referral Source | |||||||
| State: | Date of Application: | 09/21/2018 | 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, 5 years – 10 years | Gender preferred: |
Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
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 and I. We are retired and have had a corgi mix granddog whom we miss and love. She is with our daughter who had to give her to us for 2 years. | ||||||
Why do you want a Pembroke? |
We have done extensive research on the breed and as devotees of Queen Elizabeth have been observing her for many years. We have had a granddog who was mostly Corgi. We love the sidelooks she gave us just before she quickly began to play with us, the looks when she wanted us to do her bidding, the looks that meant she expected us to live up to her standard of loving care!!! She was hilarious and so very loving. | ||||||
Activities planned with Pembroke: |
We have always kept a pretty consistent schedule with our dogs. We walk them, take them to the dog park, errands and along side of us during the day. | ||||||
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 have never had puppies and our dogs were part of the family and we did not have to discipline that we can remember. | ||||||
Discipline: |
To encourage and reward good behavior we used hugs, praise and treats. | ||||||
Where would Pembroke spend the majority of the time: |
With us. We have one car which we share and the dog would have someone home most of the time or go out with us. | ||||||
Discipline: |
To encourage and reward good behavior we used hugs, praise and treats. Where would Pembroke spend the majority of the time: With us. We have one car which we share and the dog would have someone home most of the time or go out with us. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. | ||||||
Where would dog eat? |
In our kitchen | ||||||
Where would dog sleep: |
Preferably in our bed but some Corgi's like to sleep at the edge of the bed or in their own bed. | ||||||
Play & exercise: |
We will have a routine that we are very used to. I take the dog early in the morning for a long walk. Then to the dog park with my husband around 10. Then short walks, then a long walk at night. | ||||||
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: |
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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
We live in a large one story duplex. We have a large back porch with a rail that the dog could not get out of. We live in a very quiet neighborhood with lots of dogs on leases. | ||||||
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? |
John | ||||||
Willing to train children? |
no grandchildren under 9. Both grandsons (9 and 12 ) have their own dogs (our former dogs we cared for while their mothers and Dads were not able to) who sleep with them. We are a totally dog loving family. | ||||||
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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? |
we have no other pets and our granddogs do not make the trip to visit us. | ||||||
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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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