| Date & Referral Source | |||||||
| State: | Date of Application: | 10/05/2018 | 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: |
Either a Male or a Female | Color preferred: |
Red & White, Red Headed Tri, Sable & White | Activity level: |
Outgoing, Quiet, Playful, Energetic |
Other preferences: |
I am in my late sixties and my activity level is moderate. I own my house where there is a nice fenced back yard. My grandchildren range in age from 5-14 and in their homes they all are used to being around dogs, cats, snakes, and lizards. We had a Labrador retriever when I was growing up; while raising kids we had two rescue dogs and a cat who were integral to our family. As a single adult I lived for 14 years with two rescue cats who were brothers. I have a preference for a short-haired corgi over a long-haired one, but that's not a deal-breaker. | ||||||
| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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Dog 1 name: |
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| Dog 2 | |||||||
Dog 2 name: |
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Dog description: |
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| Dog 3 | |||||||
Dog 3 name: |
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Dog description: |
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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? |
I am a single retired woman recently relocated from Seattle to Michigan to live near my kids, grandkids and friends. | ||||||
Why do you want a Pembroke? |
I have casually known two people who had Corgis. In interactions with them I found corgis to be smart, active, and friendly. I've also been impressed that they were not aggressive or hostile in general toward people and other dogs. I've done some research about corgis over the past year on the internet. | ||||||
Activities planned with Pembroke: |
Aside from walks in our neighborhood and parks, I'm a big gardener and spend a lot of time outside as the Michigan weather allows. I do have arthritis and have found that staying active is the best way to stay healthy, but I won't be doing any strenuous hiking, for example. It would be great if my corgi liked traveling in a car so we could take trips together. I've found from knowing my sisters and their dogs that dogs are happy when they are active and have responsibilities. – whether that's something organized like agility or informal like learning obedience or their role in the family. | ||||||
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: |
Vocal commands, lead correction, and redirection; reinforce desired behavior. I'd also want to understand what provoked the "mistake" so we could lessen the possibility of that happening again regularly. | ||||||
Discipline: |
Verbal or lead correction; practice and reinforce desired behavior. Remove from overstimulating situation to a quiet space. | ||||||
Where would Pembroke spend the majority of the time: |
Inside or outside where I am. | ||||||
Discipline: |
Verbal or lead correction; practice and reinforce desired behavior. Remove from overstimulating situation to a quiet space. Where would Pembroke spend the majority of the time: Inside or outside where I am. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, me. | ||||||
Where would dog eat? |
In the kitchen. | ||||||
Where would dog sleep: |
Inside the house where he was most comfortable. On his bed in my room would be fine. | ||||||
Play & exercise: |
We have dog parks here in addition to a nice neighborhood for walking and a fenced in back yard. | ||||||
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? |
The fence is chain link and about 3 1/2 feet high. | ||||||
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: |
I have a basically flat lot with a lawn and gardens which I am going to be enlarging. There is a detached garage. No pools or other fixtures. | ||||||
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? |
Kris (self) | ||||||
Willing to train children? |
Yes, I am willing to teach my grandkids how to humanely care for animals. They have animals in their own homes and are kind and respectful of them. | ||||||
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Any allergies? |
No one is allergic. | ||||||
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? |
NA | ||||||
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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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