| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 05/27/2019 | 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: |
3 years – 5 years, 5 years – 10 years, 10 years + | Gender preferred: |
Male | Color preferred: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color | Activity level: |
Outgoing, Quiet, Playful |
Other preferences: |
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| Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
For my family — Tony, Judy and Edwina (PWC-female, 9 years) | ||||||
Why do you want a Pembroke? |
My family — particularly me, as the primary resource — has enjoyed the company of corgis for nearly 25 years. Our first, Furball, was a tri-color, silky, who lived to be 14 years old. When he died, the empty space in our home and lives was more than I could bear. I found a loving breeder in Iowa, and soon brought home Einstein, a 10-week old, red and white PWC. He filled our house with love, laughter, activity, challenge and love. When he was a year old, I brought home Edwina, a 10-week old, red and white PWC. She added an incredible dimension to an already perfect family with her humor, love, management skills (she moved in and took charge of Einstein and all of us quite ably). For 10 years, Einstein and Eddie have entranced every person and dog they meet. Fitting together like a glove, Einstein always on the right and Eddie on the left; Einstein leading the way with his enthusiasm and wit and energy, Eddie following, always slowing down the pack with her need to scavenge and eat and explore. We have educated the world we met each and every day about the PWC, origin, characteristics, energy, verve, intelligence, wit, curiosity and loyalty. In December, we lost our beloved Einstein to stomach cancer. He was fine one day, the next he could no longer walk. He died at the emergency pet hospital, in my arms, ears back and eyes down. The breeder, when informed, told me corgis are very stoic and that is why I didn't know he was sick. Since his death Edwina (Eddie) has mourned and grieved. I have watched her struggle with being a solo, as opposed to a part of a pair; a pair in which her partner, Einstein, was completely adored and cherished. While Eddie has adjusted, I feel her loss daily and in my heart I feel she is lonely, even though she has me and Tony. The space left empty by Einstein's passing is large and I feel the urge to fill it with a companion for me and Tony and Eddie. I would love most to fill the space with a corgi, or corgi mix, but the window to bring a new dog into the household is short, in my mind. Eddie is 9 years old and the longer she spends time alone, I sense the less likely it is she will adapt to a new dog companion. | ||||||
Activities planned with Pembroke: |
Walk the neighborhoods, which are filled with people, dogs and traffic. Go to the park. Watch tv, eat meals, read books, sit on the balcony. Visit with friends. | ||||||
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 |
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|
Do you have a veterinarian? |
Yes | ||||||
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: |
Depends on the mistake. Growling or aggression — a firm no and remove from situation so no one is hurt. Bathroom accident — quietly clean up with no comment; praise when bathroom needs are accomplished outside. Continual mistakes such as aggression, growling, chewing, destruction — talk to vet and rule out medical issue, add in more activity and stimulation to address boredom or anxiety, bring in a trainer to work on behavior. | ||||||
Discipline: |
Tone of voice is adjusted to meet the severity of discipline required. Never strike, push or use force. Corgis are very strong willed and intelligent, so I have to rise to challenge and firmly establish myself as the alpha. I am in charge and the dog needs to understand and accept my role in his life. | ||||||
Where would Pembroke spend the majority of the time: |
Depending on the corgi, I would consider crating until he is comfortable and has adapted to his new home and companions. Once acclimated, we allow our corgis to go where they like to go in the house. We have a cover for the couch, as Einstein used to like to sleep on the couch. We have a dog bed for each pup. | ||||||
Discipline: |
Tone of voice is adjusted to meet the severity of discipline required. Never strike, push or use force. Corgis are very strong willed and intelligent, so I have to rise to challenge and firmly establish myself as the alpha. I am in charge and the dog needs to understand and accept my role in his life. Where would Pembroke spend the majority of the time: Depending on the corgi, I would consider crating until he is comfortable and has adapted to his new home and companions. Once acclimated, we allow our corgis to go where they like to go in the house. We have a cover for the couch, as Einstein used to like to sleep on the couch. We have a dog bed for each pup. |
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|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
All day, for the most part. | ||||||
Where would dog eat? |
We feed the corgis in the kitchen. | ||||||
Where would dog sleep: |
We have dog beds, but find that corgis roam and sleep in multiple spots during the night. Einstein slept in the closet; Eddie sleeps on the floor next to her dog bed. We don't have the corgis sleep in bed with us. | ||||||
Play & exercise: |
Regular walks, often to the park where, if we can find a good empty spot and feel confident we can drop leashes, we throw toys for running and catching exercise. | ||||||
How will you exercise your dog? |
On leash | ||||||
|
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 a condominium in a dog-friendly building. | ||||||
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? |
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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? |
Yes | ||||||
|
Description of yard: |
NA | ||||||
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? |
Judy | ||||||
Willing to train children? |
My child is fully grown and living on his own. We began adopting corgis when he was five and a lot of the experience was learning about the breed, and learning to love and care for a living being. We always emphasized gentle hands and fingers. My son is a most loving and caring human being and he has loved all of our pets with his whole heart. | ||||||
|
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? |
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 | ||||||
|
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} | ||||||