Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 10/19/2019 | 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: |
My husband and I adopt mostly animals with special needs and disabilities. This is preferred, but we wouldn't mind adopting a "regular" corgi. We just prefer animals who need a little extra help or have disabilities that others shy away from! | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
My husband and I. | ||||||
Why do you want a Pembroke? |
My husband has been in love with Corgis his whole life. He has done research and loves everything about them. I have been looking for 2 years to get him one as a surprise. We've been prepared to add a dog into our family for about two years. | ||||||
Activities planned with Pembroke: |
My husband is very active and loves to go hiking and rock climbing out in nature. I love to go for walks and just spend time outside. Between the two of us, our dog would get a lot of outside time if that's what it likes. Our work schedules also don't always quite match up so a lot of the time there is one of us at the apartment, willing to spend time with a dog. On days where we both work, there is always somebody home by 3 as my work days end early in the evening. We are very close with our families and a few family members also have dogs who do frequent play dates. If this is something our dog would enjoy, we would do this every or every other week most likely. | ||||||
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: |
The first time it happens would be okay and we would let it slide. The second time it happened I'm sure we would discipline the dog and try to train them in how not to make this mistake again. | ||||||
Discipline: |
We would be strict and then train them using a reward system. I have never trained a dog before, as all of my rescues in the past have been house trained, but my husband has trained a dog in the past and is willing to also take it to obedience training if nessicary. | ||||||
Where would Pembroke spend the majority of the time: |
Free roam of the house. We do have one bedroom that is closed off, as we have all of our reptiles in that room. The dog could be in this room when supervised as well, but it is mainly closed off because of the cats. The dog would have free roam everywhere else, and would be outside with supervision. | ||||||
Discipline: |
We would be strict and then train them using a reward system. I have never trained a dog before, as all of my rescues in the past have been house trained, but my husband has trained a dog in the past and is willing to also take it to obedience training if nessicary. Where would Pembroke spend the majority of the time: Free roam of the house. We do have one bedroom that is closed off, as we have all of our reptiles in that room. The dog could be in this room when supervised as well, but it is mainly closed off because of the cats. The dog would have free roam everywhere else, and would be outside with supervision. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Most of the day, yes. My husband and I's schedules don't always match up so there is somebody home a lot of the time. When we do have a day where our schedules match up, there is always someone home by 3, as my work days are quite early. | ||||||
Where would dog eat? |
In the kitchen, away from the cats dishes. | ||||||
Where would dog sleep: |
Wherever he or she pleases. We would most likely have a water dish in our bedroom as well and let the dog sleep with us, but they can sleep wherever they want. | ||||||
Play & exercise: |
Often! As I said earlier, my husband and I do like to be outside a lot. He likes to hike and rock climb (more adventurous out of us two), and I like to go for walks and relax outside. Between the two of us he or will get lots of outside time and exercise. My husband doesn't mind the winter either so he will still take the dog outside in winter, if it wants to. While we are home, we will also play with the dog. We are decently active people and don't him having an active corgi or one that just wants to cuddle up with us on the couch, because we love to do that too! | ||||||
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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
We live in an apartment complex. The complex has an area where dogs can use the bathroom. There is no pool or any other fixtures like that. There is a walking path near by. | ||||||
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? |
Isaac Peterson, but we both will | ||||||
Willing to train children? |
At the time we do not have children but when we do we will of course take the time to teach them how to humanely care for all 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. Our kittens have been around dogs their whole lives and are friendly. Our rescue cat has neurological disabilities and gets overstimulated very easily, but she gets used to other animals quickly. It took roughly a month for her to get used to the kittens, and even when she is not kind to them her bark is worse then her bite. We also have 13 reptiles but they all stay in one room and will not be roaming the house and coming in contact with our dog or cats. When they are held or taken out, it is strictly in their room. |
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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} |