Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 06/15/2019 | 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, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Playful, Energetic, Very Active |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
Dog 1 |
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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? |
Us! | ||||||
Why do you want a Pembroke? |
My boyfriend and I have always loved corgis. We love how curious they are, their energy, and their lovability. I grew up with dogs always, and I’m excited to have a dog on my own with my boyfriend. We live across the street from a corgi named Rosie and she’s the sweetest pup who we love to spend time with. I also grew up across the street from two corgis. We have done extensive research on the breed and are excited to have one of our own someday. | ||||||
Activities planned with Pembroke: |
We will take our corgi on long walks, and will be at the disposal of our dog forever. We will train the dog and make sure that he/she goes to obedience classes where we will both always be there. We will make sure they’re comfortable before taking them to a dog park or bringing them around other dogs. Most of all, we plan on loving the dog to the best of our ability and making sure our dog is the happiest dog ever. | ||||||
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? |
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: |
We believe in the positive discipline method. Making sure that we reward for good behavior and that we don’t yell at our corgi when they make a mistake. We will never rub our dog’s nose in its mistake. We will use a firm tone, but make sure that the corgi still feels safe and loved. | ||||||
Discipline: |
We would take the non-aggressive approach. We would practice the following: -firm tones -time-outs/time in crate -taking their toys away for a little -not giving the dog attention when they misbehave. |
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Where would Pembroke spend the majority of the time: |
Most of the time in the house with us. | ||||||
Discipline: |
We would take the non-aggressive approach. We would practice the following: -firm tones -time-outs/time in crate -taking their toys away for a little -not giving the dog attention when they misbehave. Where would Pembroke spend the majority of the time: Most of the time in the house with us. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Sometimes. I work from home once a week. We would have a dog walker though come every day. | ||||||
Where would dog eat? |
The kitchen, with us! | ||||||
Where would dog sleep: |
Ideally on a dog bed in our room, but we can adapt to changes. | ||||||
Play & exercise: |
We will make sure that our corgi gets ample amounts of exercise. We will go on two long walks twice a day and will play with our corgi to make sure that they’re getting all the opportunities to play. | ||||||
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: |
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? |
No, you may not contact my landlord. | ||||||
Lease allow dogs: |
No, my lease does not permit dogs. | ||||||
Landlord permission: |
No, my landlord has not given me permission to adopt a Pembroke | ||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We will move if given the chance to adopt a corgi. | ||||||
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? |
Naomi david and Evan McCollam | ||||||
Willing to train children? |
If and when we have kids, we will teach them how to humanely care for animals. | ||||||
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? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
Of course. | ||||||
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} |