Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 09/18/2019 | 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 preferences: |
A playful corgi would be best because I do have a younger one currently, but I would also love to give a home to any corgi that needs one. | ||||||
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? |
Me! I currently have a tri color PWC who will be 6 months old tomorrow. He wants a friend! | ||||||
Why do you want a Pembroke? |
I currently have a PWC (6 mos old) and I've loved corgis ever since I can remember. They are the perfect dog because they aren't huge but still have the activity level that I love. I do so many things with my puppy and he loves all people and dogs! This breed is so smart and I have been training my puppy so easily. I would love to add another to my home. | ||||||
Activities planned with Pembroke: |
Walks, dog park, dog day care, swimming! I do all of these things currently with my PWC puppy. | ||||||
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? |
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: |
I have been training my puppy with positive reinforcement. I never punish him because there is no need. He has never been aggressive toward any person or dog. If he were I would remove them from the situation and keep him isolated. There is no need to hit or yell at a dog I have learned through research. | ||||||
Discipline: |
Like I said above, the dog just needs to be removed from the situation immediately and be isolated. I do not believe in hitting the dog or yelling. | ||||||
Where would Pembroke spend the majority of the time: |
At my house, or at dog day care a couple days a week if the dog is active enough. | ||||||
Discipline: |
Like I said above, the dog just needs to be removed from the situation immediately and be isolated. I do not believe in hitting the dog or yelling. Where would Pembroke spend the majority of the time: At my house, or at dog day care a couple days a week if the dog is active enough. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I have a roommate that is home most of the day (she works night shift). | ||||||
Where would dog eat? |
In my bedroom is where my puppy currently eats. I don't leave food out, I feed him at set times for his meals. | ||||||
Where would dog sleep: |
My room, if the dog is crate trained I would be okay with that, but if not I let my puppy sleep on my bed when he wants to. He still loves his crate. | ||||||
Play & exercise: |
I take my puppy on a walk before I go to work in the morning and when I get home after he eats. Sometimes I take him to dog parks near and I always try to play fetch with him daily. | ||||||
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? |
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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? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
My house is a town home, three bedrooms upstairs, a living room and kitchen on the main floor, and a finished basement. The outside is not a big yard, which is why I always take my puppy on walks and to parks nearby daily. | ||||||
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? |
Morgan Pinzer | ||||||
Willing to train children? |
I do not have children and do not plan on having children. | ||||||
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, we had that issue bringing my puppy in but now all of the animals get along. | ||||||
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} |