| Date & Referral Source | |||||||
| State: | Date of Application: | 09/24/2018 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
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? |
This Pemboke is for my daughter Lydia. We have always had a dog (had aussie/shepard currently have and aussie/poodle) My daughter has been looking for a corgi the past year and before we go to a breeder, I wanted to check with a rescue as I believe there are so many good dogs out there waiting for a good home. My daughter is a student at ASU in her final year and is in a home with a fenced yard with a dog door…timing is right for her to get a dog. It would be in her home, she works three days at an internship and has classes a few hours the other two days. I feel a dog would help her with her mild anxiety as well and give her something to take care of. She is a very responsible young lady and an "old soul" as she is not the typical college student. I look forward to hearing from you to discuss placement of a rescue Pembroke. | ||||||
Why do you want a Pembroke? |
Having herding dogs in the past, I've come to appreciate the intelligence and work ethic of the herding dogs. My daughter and I have researched the breed and have fallen in love with these little "power houses" and the expressive faces and loyalty. | ||||||
Activities planned with Pembroke: |
Play in yard, walks, socialize with other dogs | ||||||
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: |
I have trained both of my dogs myself. I vocal reprimand has always worked as dogs are intelligent and know what they have done wrong. | ||||||
Discipline: |
While training, I've used the sending to crate method while I clean up the chewed item or the "accident" The dogs have always been a part of the family and being sent to the crate has always been punishment enough… being away from the family:-( | ||||||
Where would Pembroke spend the majority of the time: |
In the house. | ||||||
Discipline: |
While training, I've used the sending to crate method while I clean up the chewed item or the "accident" The dogs have always been a part of the family and being sent to the crate has always been punishment enough… being away from the family:-( Where would Pembroke spend the majority of the time: In the house. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. | ||||||
Where would dog eat? |
in the kitchen | ||||||
Where would dog sleep: |
in bedroom | ||||||
Play & exercise: |
every morning walk before work and evening strolls around the yard or out in yard while I work on the yard and pull weeds – LOL! | ||||||
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? |
6' white paneled fence | ||||||
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: |
open back yard on a corner lot so 15' deep but 40' wide. | ||||||
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? |
Myself | ||||||
Willing to train children? |
Children have always had pets. Dogs, fish, turtle, hampster… | ||||||
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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? |
Absolutely | ||||||
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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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