| Date & Referral Source | |||||||
| State: | {Applicant State:2} | Date of Application: | 06/05/2019 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
|||||||
| 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? |
We love Corgis and would love to add one to our family some day! They would be a true member of the family and very well cared for in our home! ? | ||||||
Why do you want a Pembroke? |
My husband actually introduced this breed to me. About 10 years ago when we were dating, we were dreaming of our future home and what kind of dog we would want. When he said Corgi I had no clue what he meant. Then he showed me a picture and that’s all it took! We’ve been dreaming of having a corgi in our family ever since! We love dogs in general and would prefer to adopt a rescue pup because we know they need homes. But corgis are typically hard to find so we just figured we may never get one, until I found your organization! We love that they are energetic and like to play, we love their size as we have typically had only larger dogs in our life, and we love their adorable little wiggle butts when they walk! | ||||||
Activities planned with Pembroke: |
We are home-bodies, so on most days we would be hanging out in our large, fenced-in backyard, playing with toys, or taking a walk in our quiet, old, and safe neighborhood, or unwinding with snuggles on the couch after a long day. We love to camp too so we could see some camping adventures in our future! | ||||||
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? |
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: |
We use our words and face to show puppies when they did something wrong. If they had an accident or did something “bad”, we would tell them know and try to show them what we are talking about so they can see what we mean. We don’t hit our dogs but use firm tones with our words when they need to be shown some authority. | ||||||
Discipline: |
Same as above, mainly just using the word no when needed. Our dog Phoebe knows exactly what we are saying when we tell her no so we find this very effective. I also think training classes could be very beneficial to a dog! | ||||||
Where would Pembroke spend the majority of the time: |
Depending on how they do out and about in the house, we would allow them to roam free in the home. Our current dog does not have a kennel but that’s because she doesn’t like them and doesn’t need one. We will cater to our dogs needs to make them the most at home they can be. We will either be inside where the dog is allowed on our furniture or outside playing in our big backyard! | ||||||
Discipline: |
Same as above, mainly just using the word no when needed. Our dog Phoebe knows exactly what we are saying when we tell her no so we find this very effective. I also think training classes could be very beneficial to a dog! Where would Pembroke spend the majority of the time: Depending on how they do out and about in the house, we would allow them to roam free in the home. Our current dog does not have a kennel but that’s because she doesn’t like them and doesn’t need one. We will cater to our dogs needs to make them the most at home they can be. We will either be inside where the dog is allowed on our furniture or outside playing in our big backyard! |
||||||
|
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, but not all the time, it just depends on the work schedule. We also have family across the street who will come hang out with our pup if we have an unforeseen reason we can’t get home in time. | ||||||
Where would dog eat? |
Whatever is recommended by the previous owner or by our vet. | ||||||
Where would dog sleep: |
Ideally, in a dog bed in our bedroom. And occasionally in our bed on special nights when we need cuddles! | ||||||
Play & exercise: |
We have a large fenced in backyard and a big neighborhood to take walks. We take walks every evening and love to spend afternoons and weekends outside! | ||||||
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? |
Metal fence completely surrounding yard. | ||||||
Living arrangements: |
Own 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? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
|
Description of yard: |
No fixtures, just about 3/4 an acre, with 10+ trees, and lots of open space. | ||||||
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? |
We share the duties, but I guess Eddie if we have to choose one. | ||||||
Willing to train children? |
Yes. We do not have children, but may have some in the future. We will be sure to train ourselves, the puppy, and the child appropriately. | ||||||
|
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, absolutely. | ||||||
|
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} | ||||||