Untitled_2601

Applicant IL
State: {Applicant State:2} Date of Application: 10/03/2019 Referred by: Website
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:
 1 year – 3 years, 3 years – 5 years, 5 years – 10 years, 10 years +
Gender preferred:
 Either a Male or a Female
Color preferred:
 Any color
Activity level:
 Quiet, Playful, Other (Please describe in the box below.)

Other preferences:

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}

Who is this dog for?

 I would like to adopt a Pembroke Welch Corgi to get him or her certified to become a therapy dog to take into hospitals, nursing homes, and schools as well as individual homes where I provide care. At home the dog would be treated as a member of my family.

Why do you want a Pembroke?
 I am part Welch myself (Maiden name is Jones) and I did my research on the Corgi's as a good breed to have as a therapy dog. I am open to mixed corgi breed with collie, german shepherd, lab, or retriever mixed, but also looking for a smaller dog. Not interested in a border collie corgi mix though.

Activities planned with Pembroke:
 At home the corgi would be exercised twice daily with walks and playing in the back yard. During the day he/she would accompany me with to interact with my clients. I have some clients with Asperger's and some with some physical and hearing disabilities. I want a dog that would be companionable for a wide range of locations and people. Also good with other pets as some of these people have pets.

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?

 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: 		Say no sternly and then offer positive reinforcement fpr getting the behavior correct. (Treats, love and affection).

Discipline:
 Tone of voice and positive reinforcement.

Where would Pembroke spend the majority of the time:
 1/2 at home and 1/2 serving my clients amd my community as a therapy dog.

Discipline:
 Tone of voice and positive reinforcement.
Where would Pembroke spend the majority of the time: 1/2 at home and 1/2 serving my clients amd my community as a therapy dog.

House dog or outside dog?

 House dog

People at home during the day?
 Sometimes

Where would dog eat?
 At home.

Where would dog sleep:
 In my room at home

Play & exercise:
 2 walks daily with backyard play time and occasionally walks with clients amd play time with clients.

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?

Living arrangements:
 Live with friends

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:

 No swimming pools. Neighbors both have dog fences. Back yard is very large. No fixtures other than a deck some backyard furniture and a bird enclosure.

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?
 Tammi Hoefling

Willing to train children?
 I have no young children at home. I habe two adult children who were raised with pets.

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 will seek a trainer to assist with the acclimation.

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}