Untitled_2432

Applicant IL
State: {Applicant State:2} Date of Application: 06/14/2019 Referred by: Other
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

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:
 Outgoing, Quiet, Playful

Other preferences:
 A good companion for comfort.

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}

Who is this dog for?

 The corgi is for me. I would like to adopt one that could be a good choice for a comfort dog to deal with anxiety and stress.

Why do you want a Pembroke?
 I would like a Pembroke Welsh Corgi because I fell in love with the breed when I first saw it. It reminds me of myself from what I’ve seen, researched, and heard from people. Especially for the bond I would like to have with my new friend.

Activities planned with Pembroke:
 I would like to cuddle a lot and mainly walks or drives in the car. I know other people with dogs so he or she won’t feel lonely and have play dates.

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: 		It depends on the mistake but I would make them aware of what they did and either put them outside or in the kennel long enough for my Pembrpke to understand. If it’s an accident I can’t be upset.

Discipline:
 The kennel is a good method but I don’t want it to always be looked at as a punishment when he or she has to be put in the kennel for a little while.

Where would Pembroke spend the majority of the time:
 In the house and outside.

Discipline:
 The kennel is a good method but I don’t want it to always be looked at as a punishment when he or she has to be put in the kennel for a little while.
Where would Pembroke spend the majority of the time: In the house and outside.

House dog or outside dog?

 House dog

People at home during the day?
 Yes usually my mother are home during the day and my father at night.

Where would dog eat?
 In the dinning room.

Where would dog sleep:
 In the room with me.

Play & exercise:
 I’m pretty active myself so it would be like having a companion to walk and go on runs with. So playing and exercise would be often.

How will you exercise your dog?
 On leash

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?
 It’s a Woden 8ft tall gate.

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:

 The backyard only has a patio set with concrete on one sids and grass on the other. The grill isn’t used often

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?

 No, I will not 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?
 Kiara Stallworth

Willing to train children?
 I don’t have children but if this is necessary for another child then yes.

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}