Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 09/30/2019 | 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: |
Red & White, Sable & White | Activity level: |
Other (Please describe in the box below.) |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
Our family. My husband, myself and our 2 children; Aiden (5.5) and Charlotte (4.5) | ||||||
Why do you want a Pembroke? |
We are previous owners of a Pembroke Welsh Corgi named Ein. Ein was 11 years old this past May when he crossed rainbow bridge. We are very familiar with the breed and enjoy everything about them. They are very smart and loyal and have such a personality! | ||||||
Activities planned with Pembroke: |
He would accompany us on family walks and trips. When not outside, he or she would be snuggled on the couch or asleep in one of the beds. With our hours, often times we would take our dog on errands with us. | ||||||
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: |
When our Ein chewed our vaccumm cleaner cord, we brought him back to the "crime scene" and said no! in a firm voice & showed him his toys instead. We stay calm because we want the dog to respect us, not fear us. | ||||||
Discipline: |
We believe in repetition and firm, simple commands. We do not believe in violent (hitting, beating, etc) methods, but rather work with the dog to understand our commands and be rewarded with positive reinforcement. Squirt bottles and time outs are also used by use | ||||||
Where would Pembroke spend the majority of the time: |
In our house or bed. It's a personal decision of ours not to do crate training. I have had dogs all my life (afghans, poodle, and an airedale terrier) so to me a dog is another child and belongs anywhere we are. | ||||||
Discipline: |
We believe in repetition and firm, simple commands. We do not believe in violent (hitting, beating, etc) methods, but rather work with the dog to understand our commands and be rewarded with positive reinforcement. Squirt bottles and time outs are also used by use Where would Pembroke spend the majority of the time: In our house or bed. It's a personal decision of ours not to do crate training. I have had dogs all my life (afghans, poodle, and an airedale terrier) so to me a dog is another child and belongs anywhere we are. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I (Bridgette) work overnights, one week on, one week off so I am home during the day. My husband works during the day so he is home overnight with the kids. Therefore someone is always home minus the errands and activities. | ||||||
Where would dog eat? |
From a dog bowl in our kitchen. | ||||||
Where would dog sleep: |
We would buy a dog bed for it to have a place to call his/her own but should he/she not want to sleep in it, then he/she would be welcome to sleep wherever they preferred. | ||||||
Play & exercise: |
Daily; in our yard or inside the house with the kids or myself. | ||||||
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? |
standard wood picket fence. | ||||||
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? |
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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: |
There is a small and a shed. A deck leading from our kitchen. | ||||||
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? |
Bridgette | ||||||
Willing to train children? |
Up until this past May when Ein crossed rainbow bridge, the children have grown up with dogs. My parents have a dog as well as they are very aware on how to treat 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? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
of course! everything sometimes takes time and you wouldn't give up on your toddler if they didn't like the infant and so we wouldn't give up on our dog either. | ||||||
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} |