| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 02/21/2019 | Referred by: | Website | ||
| Contact Information | |||||||
| First name: | {First Name:98} | Last name: | {Last Name:97} | First name 2: | {First Name 2:94} | Last name 2: | {Last Name 2:93} |
| Address | |||||||
| Street: | {Street Address:3} | ||||||
| City: | {City:4} | State: | {State:5} | Zip: | {Zip:6} | ||
| Type of Dog Wanted | |||||||
Ages interested in: |
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 (Please describe in the box below.) |
Other preferences: |
|||||||
| Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
Dog 1 |
|||||||
Dog 1 name: |
{Dog Name (Most recent/ current first):24} | ||||||
Dog description: |
{Description of Dog:25} | ||||||
How long owned? |
{Length of time owned:26} | ||||||
Where is this dog now? |
{Where is this dog now? (Explain if you no longer have the dog):37} | ||||||
| Dog 2 | |||||||
Dog 2 name: |
{Dog Name (Most recent/ current first):30} | ||||||
Dog description: |
{Description of Dog:33} | ||||||
How long owned? |
{Length of time owned:35} | ||||||
Where is the dog now? |
{Where is this dog now? (Explain if you no longer have the dog):39} | ||||||
| Dog 3 | |||||||
Dog 3 name: |
{Dog Name (Most recent/ current first):29} | ||||||
Dog description: |
{Description of Dog:32} | ||||||
How long owned? |
{Length of time owned:36} | ||||||
Where is dog now? |
{Where is this dog now? (Explain if you no longer have the dog):27} | ||||||
| Dog 4 | |||||||
Dog 4 name: |
{Dog Name (Most recent/ current first):28} | ||||||
Dog description: |
{Description of Dog:31} | ||||||
How long owned? |
{Length of time owned:34} | ||||||
| Where is this dog now? | {Where is this dog now? (Explain if you no longer have the dog):38} | ||||||
| Questions Regarding Motivation for Adopting and Intentions | |||||||
|
Who is this dog for? |
Ourselves. | ||||||
Why do you want a Pembroke? |
I love corgi's for their looks and for their playful but loving personalities. I have limited experience with corgi's but I grew up with a Jack Russell Terrier so I am no stranger to very active pups! I have done my research on corgi's and do feel the breed is well suited to me. I do know that corgi's require a lot of exercise, daily grooming, and are very intelligent dogs that like to be challenged. I feel I am prepared to provide all of these as well as a very loving home. | ||||||
Activities planned with Pembroke: |
Daily walks, hiking and camping on the weekends. We have a dog park in the neighborhood that I would love to take my corgi to the help socialize him with other people and dogs. I would also love to do some agility training depending on the nature of my corgi. | ||||||
Aware that Pembrokes are busy, noisy dogs? |
Yes | ||||||
|
Money for basic care? |
Yes | ||||||
Money for unforeseen medical expenses? |
Yes | ||||||
Willing to house train? |
Yes Willing to do formal training? Yes |
||||||
|
Do you have a veterinarian? |
No | ||||||
Vet contact info: |
{If yes, please provide contact information including the vet’s name, clinic name, street address, city, state, zip, and phone. Also include the website if there is one.:52} | ||||||
Will handle mistakes Pembroke makes like this: |
With behavior training, redirecting the dog from negative behaviors and providing rewards to encourage positive behaviors. Never "disciplining" for bad behaviors but instead teaching a desired or tolerable behavior. | ||||||
Discipline: |
Again, I prefer not to discipline but rather to ignore negative behaviors, such as whining at the dinner table, etc. and instead to redirect by giving the dog his own special treat in a different room during mealtimes, etc. | ||||||
Where would Pembroke spend the majority of the time: |
In our house and backyard. | ||||||
Discipline: |
Again, I prefer not to discipline but rather to ignore negative behaviors, such as whining at the dinner table, etc. and instead to redirect by giving the dog his own special treat in a different room during mealtimes, etc. Where would Pembroke spend the majority of the time: In our house and backyard. |
||||||
|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
We both work fulltime; however do have some flexibility to work from home or come home at lunch time on occasion. | ||||||
Where would dog eat? |
In the kitchen/dining area. | ||||||
Where would dog sleep: |
Likely in crate initially, then in dog bed in living room area once adequately trained. | ||||||
Play & exercise: |
Twice daily walks on weekdays and evenings playing fetch or toss in the backyard. On the weekends we like to take hikes and would love to help our corgi get socialized at the local dog park. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
|
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? |
3 1/2 foot tall coated chain-link fence. Whole backyard is fenced in. | ||||||
Living arrangements: |
Rent/lease home | ||||||
Landlord info: |
{If you rent/lease your home, please list the name, telephone number and email address of your landlord. State “Not Applicable” if you own your own home.:67} | ||||||
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 | ||||||
|
Description of yard: |
Yard is covered in grass with fence enclosing backyard. One raised garden bed and padlocked shed within fenced yard. | ||||||
Household members: |
{Describe all the people who live in your home, include names, ages and interests. For example, Mary Smith, 29, Enjoys cooking, dog training, gardening and running.:75} | ||||||
Everyone in household agrees about adopting a corgi? |
Yes, everyone agrees and wants to adopt a Pembroke Welsh Corgi. | ||||||
|
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? |
Lauren Beckett | ||||||
Willing to train children? |
N/A – no children in the household. | ||||||
|
Any allergies? |
No one is allergic. | ||||||
Current pets: |
{Please list and describe all of the pets that currently live in your home, including the name, type, age, sex and whether it is neutered. For example, Lenny, komodo dragon, 3 years old, not neutered.:80} | ||||||
|
Current pets dog friendly? |
|||||||
Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
N/A at this time. In the future we would not adopt another pet without first ensuring they get along well with our corgi. | ||||||
|
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. | ||||||
|
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: |
{Personal References. Please list two people who know your family well, but who are not related to you (No moms, grandmas, sisters, etc) who will attest to the fact that you are a responsible, dedicated pet owner. Include the name of the person, their phone number(s), email and relationship you have with that person. For example, Mary Smith, 123-343-4444, 123-333-5767, marys@gmail.com, friend.:87} | ||||||