Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 10/04/2019 | 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, 3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
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! | ||||||
Why do you want a Pembroke? |
My parents own a PW corgi, and I also lived with a roommate who had a corgi, so I have spent a lot of time with them. I love that they are “big dogs” with big personalities that are athletic, silly, energetic, and sweet but on short legs. We want a dog that can hike and go on short runs with us. I have done a lot of research on dog training and attending training classes with the dog I grew up with and am looking forward to working with a bright (if maybe somewhat stubborn) dog that wants to learn! | ||||||
Activities planned with Pembroke: |
Running, hiking, walking, cuddling on the couch, playing in our fenced yard. We live in a very walkable neighborhood so if our dog is people and dog friendly would take with us to restaurants and cafes. | ||||||
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: |
Depends on what mistake. A potty mistake is usually the humans fault for not taking the dog out often enough or not reading the dogs signals. Otherwise, Avoiding rewarding poor behavior with affection or giving into what the dog wants (i.e not letting dog pull on leash forward, instead change direction when dog pulls) and instead rewarding the appropriate behavior. | ||||||
Discipline: |
See above question: most of the time ignore/ avoid rewarding bad behavior and instead reward good behavior. If it’s something that is really serious, I learned in a dog training class to do a quick loud sound like “eh!!” to get the dogs attention so you can redirect them. | ||||||
Where would Pembroke spend the majority of the time: |
With me or my spouse inside or in the yard (only in the yard when we are home). We both have full time jobs but I work 8 to 5 and he works 11-noon then 3pm to 10pm so our dog would not have that much time home alone. | ||||||
Discipline: |
See above question: most of the time ignore/ avoid rewarding bad behavior and instead reward good behavior. If it’s something that is really serious, I learned in a dog training class to do a quick loud sound like “eh!!” to get the dogs attention so you can redirect them. Where would Pembroke spend the majority of the time: With me or my spouse inside or in the yard (only in the yard when we are home). We both have full time jobs but I work 8 to 5 and he works 11-noon then 3pm to 10pm so our dog would not have that much time home alone. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
My spouse and I have staggered work schedules so he is home from 8 to 11 and noon to 3pm. | ||||||
Where would dog eat? |
From a bowl in the kitchen | ||||||
Where would dog sleep: |
Depending on what the corgis background is, probably in a crate indoors. Otherwise their own dog bed. | ||||||
Play & exercise: |
Will walk or go on a short run at least 2x a day. We have a fenced backyard so can also play fetch/ other dog games when outside for potty breaks. | ||||||
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? |
Solid wood fence (can’t see through it) that is 4-6ft high | ||||||
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: |
Fenced in yard. I have some gardening beds and a garden shed but no pool. | ||||||
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? |
Elaine Hutchison | ||||||
Willing to train children? |
I don’t plan on having children, but if that changes I will do this. | ||||||
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? |
Yes! | ||||||
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} |