Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 08/10/2019 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active, Other (Please describe in the box below.) |
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. We have experience in caring for dogs like Pomeranians, Chow Chows, and a Chihuahua. We now would like a Corgi companion. | ||||||
Why do you want a Pembroke? |
The decision to adopt a Corgi comes at a time where we have stability in our lives. We are ready to care and nurture for a pet as another family member. We’ve owned enough dogs to understand the commitment involved, and we’re excited to imagine our future with a corgi! We’ve done our research on the breed via corgi articles and YouTube videos. The origins of the breed as a small herding dog really endeared itself to us.
We understand that the breed is energetic and higher maintenance than most, but definitely feel it’s well worth the effort. Even though we don’t have experience with corgis, we feel confident in being able to ask via Facebook or other corgi owners for advice should an issue come up with the breed. |
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Activities planned with Pembroke: |
Definitely long walks near the park by our house! Morning jogs would also be a recurring activity. We would take the corgi along car rides around the city and provide the best toys for them to play with and enjoy their best life. | ||||||
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: |
Try and work with the corgi to correct the mistake. We understand that correcting the mistake is a process, and will take multiple attempts to get right. But patience and positive reinforcement will help us succeed. | ||||||
Discipline: |
We were trained by a Chicago Animal Shelter to use positive feedback on dogs. By this we mean using a firm yes or no to correct or reward behavior. Usually we provide treats for good behavior. | ||||||
Where would Pembroke spend the majority of the time: |
In the house with our other dog, Bear, a 5-year-old Pomeranian. When we return from work and school, we will go outside with the dogs to the park. | ||||||
Discipline: |
We were trained by a Chicago Animal Shelter to use positive feedback on dogs. By this we mean using a firm yes or no to correct or reward behavior. Usually we provide treats for good behavior. Where would Pembroke spend the majority of the time: In the house with our other dog, Bear, a 5-year-old Pomeranian. When we return from work and school, we will go outside with the dogs to the park. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. My father stays in the house during the beginning of the week and the family comes back from school/work after 2pm. | ||||||
Where would dog eat? |
The corgi would eat in my room with a self-refilling water bowl. | ||||||
Where would dog sleep: |
In my room. I would provide him/her with a bed. | ||||||
Play & exercise: |
The corgi will be taken out for walks/ runs at least three times a day. The walks/runs will be thorough, about 15-25 minutes. The trips to the park will be daily, about the same length as well, but with other activities like fetch. | ||||||
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? |
The fence is chain-linked from the front to the back. It’s always closed unless I will take the corgi outside for a walk. | ||||||
Living arrangements: |
Live with parents | ||||||
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? |
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Lease allow dogs: |
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Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
Flat, concrete back yard. The front yard has two shrubs with grass surrounding the area. There are concrete stairs in the front as well, usually we sit there during mornings or afternoons. | ||||||
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? |
Jeremy Razo | ||||||
Willing to train children? |
Yes! We constantly educate my little brother on how to treat and properly approach 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? |
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? |
We will definitely have the time and patience to resolve any conflict between the two pets! | ||||||
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} |