Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 09/25/2019 | 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 | 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: |
Sonni is very submissive, she would be afraid of a dog that tried to dominate her. I often found this was the case with larger dogs that could walk over her. She will still submit to smaller dogs if their energy level is higher than hers but she will begin to play once she isn't afraid they will hurt her. | ||||||
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? |
We currently have a 1 year old Corgi named Sonni, she is great with other dogs and cats. She is very playful and we would like to extend our home to another corgi so they both could have a friend. | ||||||
Why do you want a Pembroke? |
I have been extremely pleased with my experience with Sonni, Her energy level is perfect for me in my home. We enjoy playing her, with her size we are not worried she will break anything or cause too much damage. Her breed is also great with young children and other dogs which is very important because we enjoy visiting family/friends, Travel, and dog parks. | ||||||
Activities planned with Pembroke: |
Sonni and I walk multiple times a day in any season, and we visit the dog park in our area once a month. I am also a part of the Michigan Corgi Facebook group where we keep up on events and activities with other corgis in our area. | ||||||
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: |
Depending on the mistake, I will spend time surveying the behavior and correcting with treat rewards and repetitive praise when done correctly. If the mistake is large enough, I will seek out professional help. | ||||||
Discipline: |
I do not discipline Sonni currently, If she does something she know not to do, I may tell her "NO" loudly and speak to her in a different tone but I do not discipline her otherwise. | ||||||
Where would Pembroke spend the majority of the time: |
Our dogs have the run of our living spaces at home, they could spend time anywhere that like that I can easily observe as well as outside where we will go for walks. | ||||||
Discipline: |
I do not discipline Sonni currently, If she does something she know not to do, I may tell her "NO" loudly and speak to her in a different tone but I do not discipline her otherwise. Where would Pembroke spend the majority of the time: Our dogs have the run of our living spaces at home, they could spend time anywhere that like that I can easily observe as well as outside where we will go for walks. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
It depends on our schedule | ||||||
Where would dog eat? |
In our kitchen | ||||||
Where would dog sleep: |
In our room, preferably in a crate unless he/she is already trained to sleep outside of the crate without incident. | ||||||
Play & exercise: |
We take multiple walks a day as well as trip to our local dog park on weekends. Sonni also comes with me whenever I visit my family where she plays with kids and other dogs. | ||||||
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? |
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? |
Not applicable | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
N/A | ||||||
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? |
Alexandria Thomas | ||||||
Willing to train children? |
Yes, absolutely. | ||||||
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 I am. | ||||||
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} |