| Date & Referral Source | |||||||
| State: | Date of Application: | 11/04/2018 | 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 | Gender preferred: |
Female | Color preferred: |
Any color | Activity level: |
Outgoing, Playful |
Other preferences: |
Prefer the dog is housebroken, and not aggressive. | ||||||
| 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? |
Me, and my 10 year old Westie | ||||||
Why do you want a Pembroke? |
I love how smart and outgoing they are. They always seem friendly to people, I like that they are not timid, wallflowers. | ||||||
Activities planned with Pembroke: |
LOTS of stuffed animals in the house. Plenty of fetch and chase with my Westie. Leash walks, Winston LOVES to go out on walks. I live not to far from a beautiful dog park, (Katherine Legge Memorial Park), where they get plenty of run time in, and plenty of squirrels to chase. When Emma was healthy the two dogs had playtime first thing in the morning, after their breakfast. In the evenings, after dinner, they ran around boxing, playing chase, trying to beat each other to get the stuffed animal I had thrown, | ||||||
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: |
Since its an older dog I am seeking, I assume the dog will be housebroken. But, because of a new environment, I;m sure accidents will happen, I think the key is to keep a schedule for "out" time. The only way to break that habit is get a routine/schedule going. Also, I have a secret weapon named Winston. When Winston wants to go out he sneezes. One night he sneezed, and I let him and Emma my Sheltie out. He just stood in the yard, while Emma did "business". Winston can actually smell when a female needs to go out, and he relays the message to me, for her. | ||||||
Discipline: |
A firm, low guttural voice for corrective behavior. Then, once they know they have messed up, I ignore them for awhile. If the dog has done something positive, I reward that behavior with praise, love, and sometimes a small treat. |
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Where would Pembroke spend the majority of the time: |
In my living room, dining room, kitchen. And she would sleep with Winston and I in my bed. | ||||||
Discipline: |
A firm, low guttural voice for corrective behavior. Then, once they know they have messed up, I ignore them for awhile. If the dog has done something positive, I reward that behavior with praise, love, and sometimes a small treat. Where would Pembroke spend the majority of the time: In my living room, dining room, kitchen. And she would sleep with Winston and I in my bed. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No. | ||||||
Where would dog eat? |
In the kitchen, next to Winston | ||||||
Where would dog sleep: |
In my bed. Unless it prefers its own dog bed | ||||||
Play & exercise: |
As stated above, after breakfast there is play time for approximately 1/2 hour. In the evenings, we go for a half hour walk (unless the weather is nice) in which case we would walk further. And then, after dinner play time in the house with toys. | ||||||
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? |
4 foot high cyclone | ||||||
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 live a 1922 arts and crafts bungalow. The back yard is small, but fenced. In summer, If I am having a lazy day on the front porch, I bring the dogs out on the porch with me. There is a baby gate that I put up to keep them on the porch, . | ||||||
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? |
Katie Moran | ||||||
Willing to train children? |
I am single, and have no children. Except my Westie | ||||||
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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? |
Absolutely! I want this to work. Winston is not an aggressive dog. When he gets jealous, he just jumps up and sits next to me on the couch, | ||||||
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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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