| Date & Referral Source | |||||||
| State: | Date of Application: | 12/05/2018 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Other (Please describe in the box below.) |
Other preferences: |
I have had Australian Shepherds but other members of my family have had Corgis. Im use to there working instincts. I show horses nationally so my dogs travel with me. I only ever have 1 dog at a time so they have my conztant attention. | ||||||
| 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 have been around Corgis and Australian Shepherds all my life. I mainly have had Aussies while other members of my family have had Corgis. I lost my Aussie in May and havent replaced him. He was such q special dog and i am afraid i would compare another one to him. So i decided i would do a Corgi. So no comparison issues. I love the corgis. Many of my horse show family have them. | ||||||
Activities planned with Pembroke: |
I walk /run daily so he would go with me. The dog would travel with me . Be my companion to the horse shows. If i was gone for work or where i could not take him, i have 2 individuals who will come to my house and stay with my dog. I never use kennels, not that theres anything wrong with them. But i feel that its bad enough to have their owner gone and they need stability and comfort so a kennel just ads to the anxiety. They would stay in their own home with their own things. | ||||||
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: |
Every animals different. So depends. But showing they what he did wrong. Cage time(timeout). Working with them to help them understand they right way or better way. Alternative ways to correct the problem | ||||||
Discipline: |
Time outs. Finding ways to correct the problems. | ||||||
Where would Pembroke spend the majority of the time: |
With me in my home. There would be a cage for them to sleep in if they choose. Other wise they would have the run of the house. But always with me. | ||||||
Discipline: |
Time outs. Finding ways to correct the problems. Where would Pembroke spend the majority of the time: With me in my home. There would be a cage for them to sleep in if they choose. Other wise they would have the run of the house. But always with me. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No | ||||||
Where would dog eat? |
In my house out of their bowls | ||||||
Where would dog sleep: |
In my house in their own bed or with me | ||||||
Play & exercise: |
As i stated i walk/run daily. He would have a daily routine of exercise with me. There would also be playtime outside weather permitting | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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Fenced yard? |
No, I don’t have a fenced in yard. | ||||||
Willing to pick up dog waste? |
Yes, I will clean up after my dog. | ||||||
Willing to use a crate? |
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Living arrangements: |
Rent/lease home | ||||||
Landlord info: |
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May we contact your landlord? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
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Description of yard: |
I live in a duplex | ||||||
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? |
Dan Northcutt | ||||||
Willing to train children? |
No Children | ||||||
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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? |
N/A | ||||||
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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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