Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 07/01/2019 | 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: |
Male | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
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? |
Our family | ||||||
Why do you want a Pembroke? |
I love dogs that have a will of their own and are intelligent. Our current dog has the intelligence and will of her Corgi side and we love her as a companion. I have researched the breed quite extensively and it seems it would be a good fit for us. | ||||||
Activities planned with Pembroke: |
He would have plenty of space to play as we live a very large plot of land. He would also be associating with our current pets and would hopefully be a reliable friend and protege of our current pet. | ||||||
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: |
If "mistake" is meant as a house training issue, then we would begin scheduling regular walks and times outside to accommodate bathroom breaks. As far as a mistake in general such as disobeying a command or something like that, we would attempt to correct the behavior with positive reinforcement towards it's opposite. | ||||||
Discipline: |
For the most part, I wouldn't say that we ever discipline our dogs other than using command words to direct them. We feel a trained dog that can understand "No" and "Leave it" while also receiving positive reinforcement for obeying commands is the best way make us and them happy. | ||||||
Where would Pembroke spend the majority of the time: |
In our house or in our yard, though we will typically go for walks | ||||||
Discipline: |
For the most part, I wouldn't say that we ever discipline our dogs other than using command words to direct them. We feel a trained dog that can understand "No" and "Leave it" while also receiving positive reinforcement for obeying commands is the best way make us and them happy. Where would Pembroke spend the majority of the time: In our house or in our yard, though we will typically go for walks |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
From the hours of 8 to 5 there is generally no one home on weekdays. | ||||||
Where would dog eat? |
Starting out, probably separated from our current dog to gauge food aggression. Dogs would eat in the kitchen | ||||||
Where would dog sleep: |
Either in the bed or on a bed on the floor. Ours is trained to only be on the bed with permission, but we allow her if we aren't eating. | ||||||
Play & exercise: |
As I stated before, we live on a very large piece of land. There is plenty of room for dogs to run or fetch or go on walks with us. | ||||||
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? |
The fence lines the majority of the property. The only parts that are not fenced in are the ones a very far distance from any roads. | ||||||
Living arrangements: |
We live in a house owned by my mother-in-law and pay her rent | ||||||
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: |
We do not have a pool in our yard, but there is one on the property at the larger house. Other than that, there are no real major fixtures of the 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? |
Ethan and Erin | ||||||
Willing to train children? |
We do not have children, nor any friends who do | ||||||
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} |