| Date & Referral Source | |||||||
| State: | Date of Application: | 12/27/2018 | Referred by: | Website | |||
| Contact Information | |||||||
| First name: | Last name: | First name 2: | Last name 2: | ||||
| Address | |||||||
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| City: | State: | Zip: | |||||
| Type of Dog Wanted | |||||||
Ages interested in: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
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| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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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 4 | |||||||
Dog 4 name: |
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Dog description: |
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| Questions Regarding Motivation for Adopting and Intentions | |||||||
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Who is this dog for? |
Jonathan and Jessica Quijano | ||||||
Why do you want a Pembroke? |
We are seeking a companion for our aging (~11 yr old) Pembroke. We are strongly familiar with the breed, general temperament, personalities, and health issues through our 7 years of Pembroke ownership and from social gatherings with other Pembrokes and their owners. Based on our experiences with other breeds, we feel strongly that Pembrokes are the perfect fit for our family and lifestyle. | ||||||
Activities planned with Pembroke: |
Long walks both morning & evening. Off-leash exercises in our fenced backyard. Socializing with other dogs in our neighborhood and nearby dog parks. Participation in corgi gatherings in both Michigan & neighboring states. Travel together throughout the country as a 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? |
Yes | ||||||
Vet contact info: |
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Will handle mistakes Pembroke makes like this: |
We assert ourselves as the dominant figure in the household and look the dog straight in the eyes w/ a firm verbal "No" and "Bad" immediately after dog makes the mistake. | ||||||
Discipline: |
We train by using praise and treats for good behavior. We apply consistency in commands and signals used to communicate with the dog. Aggressive behavior is never rewarded. | ||||||
Where would Pembroke spend the majority of the time: |
Indoors with the family in the main living area of the house. Additionally, the Pembroke would be able to go to Jessica's place of work, as it is dog-friendly office. | ||||||
Discipline: |
We train by using praise and treats for good behavior. We apply consistency in commands and signals used to communicate with the dog. Aggressive behavior is never rewarded. Where would Pembroke spend the majority of the time: Indoors with the family in the main living area of the house. Additionally, the Pembroke would be able to go to Jessica's place of work, as it is dog-friendly office. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
During standard working hours both owners will be at work, but the Pembroke would be able to go to Jessica's place of work, as it is dog-friendly office. | ||||||
Where would dog eat? |
Indoors in our kitchen, where our current Pembroke eats. | ||||||
Where would dog sleep: |
Indoors in our bedroom, where our current Pembroke sleeps. | ||||||
Play & exercise: |
Long walks both morning and evening. Off-leash exercises and playtime in our fully fenced backyard (~60ft x 60ft). Daily playtime including fetch, running, tugging, agility/obstacles and snuggles. Socializing with our current Pembroke as well as other dogs in our neighborhood and nearby dog park. | ||||||
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? |
Grassy backyard is fully enclosed (~60ft x 60ft) with a wood slat/board fence. | ||||||
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: |
Grassy yard w/ some trees (no other obstacles). Fully fenced 60ft x 60ft back yard | ||||||
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? |
Jonathan and Jessica Quijano | ||||||
Willing to train children? |
Yes, we teach children how to respect and properly touch animals. | ||||||
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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? |
Yes. | ||||||
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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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