| Date & Referral Source | |||||||
| State: | Date of Application: | 02/08/2019 | Referred by: | Website, 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
Get along with cats and children | ||||||
| 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? |
It’s for us! | ||||||
Why do you want a Pembroke? |
We love their one of a kind personality. While we have not owned a Corgi, I have been doing research on the needs of the breed. Behaviors (and the need for training), such as protective of food, their intellectual abilities, energy level (although it appears to be a spectrum based on the individual dog)., and some of their common health issues. | ||||||
Activities planned with Pembroke: |
Depending on their age, activity level and needs, we could run around the house, the yard. We live across the street from a small lake with a walking path around it. Corgi meet up get togethers, snuggling on the couch. | ||||||
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: |
Depending on the dog and their background as well as the behavior , it would vary. In addition, if the mistake was made right in front of us it would be addressed immediately. | ||||||
Discipline: |
Verbal redirection, positive reinforcement for good behavior, especially if it’s shortly after discipline has taken place. Reteaching is also another something to try. | ||||||
Where would Pembroke spend the majority of the time: |
With us and the cat | ||||||
Discipline: |
Verbal redirection, positive reinforcement for good behavior, especially if it’s shortly after discipline has taken place. Reteaching is also another something to try. Where would Pembroke spend the majority of the time: With us and the cat |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Depending on if I’m in school or not, I could be home during the day. If I’m at school, I live less than a mile from work and go home for lunch. | ||||||
Where would dog eat? |
It would have its own spot | ||||||
Where would dog sleep: |
With us | ||||||
Play & exercise: |
He/she will have daily walks and exercise and play | ||||||
How will you exercise your dog? |
On leash | ||||||
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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: |
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: |
Just a yard with a small patio. | ||||||
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? |
Rachel and Michael | ||||||
Willing to train children? |
Yes absolutely | ||||||
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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, of course. | ||||||
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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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