Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 10/23/2019 | 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: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Male | Color preferred: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White | Activity level: |
Couch Potato, Outgoing, Playful |
Other preferences: |
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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? |
Both me and my Boyfriend | ||||||
Why do you want a Pembroke? |
I love corgis, i love their size and their calm yet playful demeanor. They are super cute and i cant get enough of them. I met a couple a long time ago that rescued a corgi and that was the first time I got to actually interact with one and I was instantly in love. I haven't done much research on them except for the fact that they are cattle dogs, meant to be on a farm, they've been around for 3,000 years and queen Elizabeth owned I think 6 of them. | ||||||
Activities planned with Pembroke: |
I would love to go to the park, on trips, car rides, take him to work to hang out with the other dogs. (Dog friendly office) Buy him a pupachino from starbucks, hang out at home, play in the backyard and just enjoy the time I have with my dog. | ||||||
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: |
Im not a punishment type of person so their would not be any "Crate time" hitting or scolding. Im assuming "mistake" means peeing in the house, at first I'd try to do some research on how to fix that and work with him, if that fails id probably seek a trainer to help me understand him and why he's making these "Mistakes" | ||||||
Discipline: |
I usually just re direct behaviors in order to stop one. if he keeps chewing on shoes Ill give him a toy he can chew instead. It seems to work with my cat. | ||||||
Where would Pembroke spend the majority of the time: |
Most of his time would be spent with me at work, or at home with my boyfriends parents where he'll have access to the backyard. On the weekends we go out, enjoy the day, park, shopping, car rides, day trips. Or spent some snuggle time on the couch. | ||||||
Discipline: |
I usually just re direct behaviors in order to stop one. if he keeps chewing on shoes Ill give him a toy he can chew instead. It seems to work with my cat. Where would Pembroke spend the majority of the time: Most of his time would be spent with me at work, or at home with my boyfriends parents where he'll have access to the backyard. On the weekends we go out, enjoy the day, park, shopping, car rides, day trips. Or spent some snuggle time on the couch. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Stevens parents are home, they are retired. | ||||||
Where would dog eat? |
Id probably keep his bowls in the kitchen or near our dining room table. | ||||||
Where would dog sleep: |
In his doggie bed, the couch, our bed or the futon in the second bedroom. Wherever he's most comfortable. | ||||||
Play & exercise: |
Id bring him to the park, have toys for him at home, play in the backyard. We also go out on the weekends to see family and to just get out. If i can take him with me where ever i go, he will most definitely come. He will get daily walks, multiple time s a day as well as time in the park, backyard and walks with me to the store as well as maybe a day in the city. I like to walk so he'll definitely be going on walks around the city or Brooklyn just to get out doors. | ||||||
How will you exercise your dog? |
On leash | ||||||
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? |
Its a wooden 6ft fence. | ||||||
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? |
No | ||||||
Description of yard: |
Its a medium sized yard with a 6ft wooden fence. A small garden and table are in the yard. | ||||||
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? |
Amanda Serrano (Me) | ||||||
Willing to train children? |
Absolutely, My children will always be taught to respect and love 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? |
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? |
I think my cat will have more of an issue with the dog than the dog with the cat. She can be kind of skittish but also curious. | ||||||
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} |