| Date & Referral Source | |||||||
| State: | Date of Application: | 12/01/2018 | 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: |
Red & White, Red Headed Tri, Sable & White | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
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? |
myself | ||||||
Why do you want a Pembroke? |
I like the looks and size of the Corgi. I know they can be energetic but I'm hoping there might be one for me who is not so much. One that wouldn't sitting in the house being a couch potato but also likes to go outside to play with the chihuahuas if she so please. Going on occasional walks and visits to a friend with a dog would be good also. We visit there almost weekly, everyone gets out to play, have treats and enjoy a different scene. I like the smaller dogs but have no direct experience with Corgi's and I'm starting to read about them more since Susan has passed away but am not in a hurry to replace her. Right now is too soon, we're still grieving but after a while we'll be ready for a new friend. |
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Activities planned with Pembroke: |
Walking in the neighborhood and over in St. Paul when visiting there. Play catch the ball or any other activity she might like. |
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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: |
Firmly say no and move on. | ||||||
Discipline: |
voice commands like no or just calling their name, chihuahuas can be a bit noisy at times, they like to say "hi" to everyone who walks by. | ||||||
Where would Pembroke spend the majority of the time: |
Mostly in the house unless we go outside for fun, business or just sitting out enjoying the weather. | ||||||
Discipline: |
voice commands like no or just calling their name, chihuahuas can be a bit noisy at times, they like to say "hi" to everyone who walks by. Where would Pembroke spend the majority of the time: Mostly in the house unless we go outside for fun, business or just sitting out enjoying the weather. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
no | ||||||
Where would dog eat? |
kitchen | ||||||
Where would dog sleep: |
bedroom where the kennel is located and/or on dog pillows in the same room. | ||||||
Play & exercise: |
I have a fenced yard so they can go out and play for short times when I'm home, plus walks around the block and around the near park/school. We also visit mainly on weekends in St. Paul where we can walk around the blocks and/or go to the Como Park area for walks. | ||||||
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 chain link around the whole yard with 3 gates, 2 of which are always locked against potential "shenanigans", sometimes people are just mean or don't know better. Plus we have a smaller fenced in area about 2 feet high that can be closed off to confine them while we all sit and read on the the north side. | ||||||
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: |
Fenced in city lot with many trees and bushes., much exploring is done as we have rabbits who live nearby and or in the the yard possibly under an evergreen.. | ||||||
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? |
Mike | ||||||
Willing to train children? |
no children at home but try to teach any allowed by parents to visit. | ||||||
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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? |
Sure, we'll work on that. | ||||||
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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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