| Date & Referral Source | |||||||
| State: | Date of Application: | 01/17/2019 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
We have two cats and one dog (a lab mix) who is 10 months old. | ||||||
| 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? |
Both myself and Meghann. | ||||||
Why do you want a Pembroke? |
Meghann's great aunt owned a corgi when she was growing up. Meghann fell in love with the breed; their personalities, energy, and stature made Meghann long for her own corgi. We have done research on the breed and realize that they can be high energy, however we are more than willing to work with and love any corgi that may join our family. | ||||||
Activities planned with Pembroke: |
Play outside in our fenced in yard, go on walks/jogs, lounge in the house, cuddle, nap, play with toys, go to pet stores to pick out a new toy, etc… | ||||||
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, showing how to properly handle situation (for example, if the corgi potties in the house, immediately take him/her outside), more training | ||||||
Discipline: |
stern verbal correction | ||||||
Where would Pembroke spend the majority of the time: |
in our home with Meghann and I | ||||||
Discipline: |
stern verbal correction Where would Pembroke spend the majority of the time: in our home with Meghann and I |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
there is usually no one home between the hours of 8 AM to 3 PM | ||||||
Where would dog eat? |
in the dining room | ||||||
Where would dog sleep: |
with us | ||||||
Play & exercise: |
we have a fenced in yard, so we will play with the corgi there. we also love to play with toys inside the house and go on walks in our local parks and neighborhoods. Our corgi will get to play and exercise until he/she no longer wants to. | ||||||
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? |
We have a 4 ft chain link 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: |
We have a .5 acre yard that is fenced in. We have grass and a few trees, but that is all. | ||||||
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? |
Meghann | ||||||
Willing to train children? |
yes | ||||||
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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? |
We have introduced all of our pets to each other. It would take VERY EXTREME circumstances for us to give up on helping our animals live peacefully together. We will go to great lengths to resolve any issues. | ||||||
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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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