Untitled_2471

Applicant IL
State: {Applicant State:2} Date of Application: 07/07/2019 Referred by: Friend
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:
 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, Quiet, Playful, Energetic

Other preferences:
 We have three children ages 9, 7 and 5. They are good with animals (we used to have a cat). We do not have any other animals (and would just like one dog). A friendly dog used to people and some action around the house would be great.

Previous dog owner?
 No
 
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?

 Our family

Why do you want a Pembroke?
 I (Erin) grew up around horses / barns and corgi’s were around a lot. They were always friendly and I liked their happy nature. I have always wanted one since. I grew up with an Australian Shepard dog.

Activities planned with Pembroke:
 Walks, playing outside, maybe some car rides (if the dog could tolerate that). We currently do not travel much and I (Erin) am home a lot so he/she wouldn’t be alone for long stretches of time.

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: 		Tell the dog no and take care of the issue

Discipline:
 We don’t currently have a dog. My experience in the past was to award good behavior (pats / enthusiastic words/ maybe a treat) and say no to unwanted behavior. Would consider formal training if need be.

Where would Pembroke spend the majority of the time:
 At our home with me (Erin) and our family. Taking walks (I am very active) and being outside.

Discipline:
 We don’t currently have a dog. My experience in the past was to award good behavior (pats / enthusiastic words/ maybe a treat) and say no to unwanted behavior. Would consider formal training if need be.
Where would Pembroke spend the majority of the time: At our home with me (Erin) and our family. Taking walks (I am very active) and being outside.

House dog or outside dog?

 House dog

People at home during the day?
 Yes – me (Erin) typically only gone for short periods of time. Kids / husband as well (shorter periods).

Where would dog eat?
 Inside the home – probably in our laundry room (main level, right next to kitchen)

Where would dog sleep:
 Main level of home. Dog bed or where it was comfortable.

Play & exercise:
 I am active and enjoy being outside. Walks between me and my kids. We have Avery large backyard (almost an acre).

How will you exercise your dog?
 Both on leash and restrained to the yard

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?

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:

 Large backyard, almost an acre. Neighbors on both sides. No pool. Quiet street.

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?
 Erin

Willing to train children?
 Absolutely. We have had a cat and spent time with our kids on this.

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?

Are you willing to work on it if your new dog doesn’t get along with your current pets right away?
 We don’t have any other pets and don’t want any other let’s besides one dog

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}