Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 10/27/2019 | 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: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
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? |
We are looking for a dog for ourselves. We have had two adult rescue dogs (now deceased) in the past. They were wonderful dogs and we were honored to have them as part of our family. | ||||||
Why do you want a Pembroke? |
We are very familiar with Corgi's. Both our brothers have owned a Pembroke and a Cardigan Corgi. We have found them to be wonderful dogs with lots of personality. We have had three dogs over the last 25 years, mostly larger dogs. We find that Corgis are very much like a big dog – just with shorter legs! We aren't adverse to shedding and really miss going for walks with our dog. I have researched the AKC website and studied the characteristics of Corgis. | ||||||
Activities planned with Pembroke: |
We love to walk. We have always had "pocket dogs" – ones that go with us. I am retired from teaching and my husband's office is in the home, so we are with our pets most of the time. We have done obedience school and agility classes with out previous dogs and we have two high quality doggie day care businesses near our home. | ||||||
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: |
We believe in being firm, but most importantly being consistent. If pet owners discipline for something sometimes and not at other times, you can't expect the dog to know. | ||||||
Discipline: |
Saying "no" is a voice that lets the dog no they have done something wrong. We believe in using lots of praise for good behavior. | ||||||
Where would Pembroke spend the majority of the time: |
With us. We are both home. We have an enclosed backyard and an underground fence in the front. | ||||||
Discipline: |
Saying "no" is a voice that lets the dog no they have done something wrong. We believe in using lots of praise for good behavior. Where would Pembroke spend the majority of the time: With us. We are both home. We have an enclosed backyard and an underground fence in the front. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. I am always home and my husband is home when he's not traveling. Our daughter is in college. | ||||||
Where would dog eat? |
We have a mud room. That has always worked very well as a feeding station. | ||||||
Where would dog sleep: |
With us. All our dogs have slept on dog beds in our room. We've also used a dog step ladder when they got older so the can cuddle in bed. | ||||||
Play & exercise: |
We have a great neighborhood for walking and a big yard. We have neighbors with friendly dogs that love to play. We have always loved to go for walks and we have used doggy day care for fun. We have two dog parks near our home. | ||||||
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? |
Our back yard is enclosed. We have an underground fence in the front. We are experienced in training for that. | ||||||
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: |
Large front and back yard. Plenty of trees and shade. No swimming pools. | ||||||
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? |
Kelly | ||||||
Willing to train children? |
Our daughter is 20 years old and at college. She loves animals very much. | ||||||
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. Both of our cats were raised with dogs and were very attached to our last dog. We believe with proper supervision, that our Pembroke will learn to behave and respect our cats. | ||||||
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} |