| Date & Referral Source | |||||||
| State: | Date of Application: | 12/04/2018 | Referred by: | Other | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
| Address | |||||||
| Street: | |||||||
| City: | State: | Zip: | |||||
| Type of Dog Wanted | |||||||
Ages interested in: |
5 years – 10 years, 10 years + | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
We live in a town home and do not have a fenced yard, but my parents who live across the street do, and our past dog had a lot of freedom to play in their back yard. | ||||||
| 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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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? |
David and me – we are a couple in their 50's. We had a very successful rescue corgi placement from Ohio Valley (we have applied to them for another as well – but we understand just how rare adoptable corgis are) for five years, Shelby came to us at age 9 and died in the spring at 14. | ||||||
Why do you want a Pembroke? |
We love the big dog attitude and feel in a smaller body that works well in our town home. We also love the intelligence and curiosity of the breed. I am Welsh by birth, so that is a draw too. We are highly familiar having been successful rescue owners for the past five years | ||||||
Activities planned with Pembroke: |
Walks daily, play daily, and time visiting my parents. Also all the necessary dog things of baths, vet visits etc. Our last dog really liked car rides so we might do that, depending on the new one. | ||||||
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: |
Verbal correction, removal of the temptation/cause, reducing the likelihood of it happening again by doing our side of it (not leaving food on a low surface for instance), removal of the dog from the situation, exposure of the dog in a controlled way to the situation (say other dogs if he was aggressive) with leash and direct control | ||||||
Discipline: |
Verbal and removal primarily. we will use a leash to control behavior when needed | ||||||
Where would Pembroke spend the majority of the time: |
At our house | ||||||
Discipline: |
Verbal and removal primarily. we will use a leash to control behavior when needed Where would Pembroke spend the majority of the time: At our house |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
We both work fulltime. For our past corgi we had a regular dog walker who came at around 1 pm daily for a 30 minutes walk. It worked well. We are home until about 8:30 in the morning, and back by 5:30 | ||||||
Where would dog eat? |
A healthy dog food as recommended by our vet. The last corgi had food related skin allergies so he was on a special diet. | ||||||
Where would dog sleep: |
in our bedroom – our last corgi had a bed in our room and it worked well | ||||||
Play & exercise: |
We want a dog because we are missing this part of our life, we would walk 3-4 times daily and lots of play | ||||||
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 fenced in yard is actually across the street at my parent's house – it is fenced around with a solid gate. Shelby enjoyed it and was well restrained by it. He did not ever escape. we would closely watch a new dog to check that he was well restrained too | ||||||
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: |
N/A | ||||||
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? |
David Owen-Cruise | ||||||
Willing to train children? |
No children in our direct lives – but we have found that other children are very attracted to the corgi (his height and teddybearishness I think) and so we worked with Shelby to be gentle and responsive | ||||||
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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? |
Yes – 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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