Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 11/19/2019 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years | Gender preferred: |
Female, Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
We prefer a female, but would consider a male. Color isn't a factor, but we would really like to have a younger dog so their activity level more closely matches our current puppy. | ||||||
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? |
For my husband and I. We are new to the breed and have fallen in love. We have a 5 month old Pembroke and we would really like to find another. We did purchase her through a breeder, but our hearts are telling us that we need to find one that we can rescue. Both of our previous dogs (who both passed away this year) were rescues and it is honestly our preference to do so. We don't have any kids so we put all of our time into our dogs, who make our family complete. | ||||||
Why do you want a Pembroke? |
We love our Penny (Pembroke) who we got about 1.5 months ago. She is the spunkiest, funniest little dog and we just love spending time with her. Pembrokes are a new breed for us and we are spending a lot of time learning about her and what her needs are. | ||||||
Activities planned with Pembroke: |
We love to take Penny for walks in our large yard (we are working on going down the road, but she is still learning that cars are not too scary). We have purchased a few different puzzle/games that keep her brain active and engaged. We enjoy going on hikes and walking in the woods. We also try and socialize her with other dogs as much as possible. So far, our puppy loves to play with other dogs. | ||||||
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: |
Redirect and understand that mistakes happen. When our puppy has accidents on the floor or starts to chew on something she shouldn't, we either take her right outside or we give her something that she is allowed to chew on. | ||||||
Discipline: |
We use redirection and often times just ignore her. Sometimes if she is really naughty (again, chewing on things she shouldn't be) she gets a little time out in her penned off area where she can't get to us. | ||||||
Where would Pembroke spend the majority of the time: |
We have an area in our front porch (enclosed) that we have closed off by a baby gate. Our puppy has ample room to move around (I think it is approx. 5' x 10'). We have her bed and food in there for her. She is only up there at night and during the work day. Otherwise, she follows us wherever we are. We spend a lot of time outdoors playing and walking. | ||||||
Discipline: |
We use redirection and often times just ignore her. Sometimes if she is really naughty (again, chewing on things she shouldn't be) she gets a little time out in her penned off area where she can't get to us. Where would Pembroke spend the majority of the time: We have an area in our front porch (enclosed) that we have closed off by a baby gate. Our puppy has ample room to move around (I think it is approx. 5' x 10'). We have her bed and food in there for her. She is only up there at night and during the work day. Otherwise, she follows us wherever we are. We spend a lot of time outdoors playing and walking. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
We do both work full time M-F, but I come home on my lunch break. We are home by 3:30 pm and remain home other than maybe a quick errand. We are home most weekends. If we are not home, we have been taking our puppy with us and plan to do the same with another dog/puppy. | ||||||
Where would dog eat? |
That would all depend on if there is food aggression between my current puppy and any adopted puppy. If there are issues with that, we would separate the two during meal times. We would just need to see how they behaved together to make that determination, I think. | ||||||
Where would dog sleep: |
If the puppy/dog is potty trained, we have always allowed our dogs to sleep in a dog bed on the floor of our bedroom. We currently have our puppy in an enclosed area at night, because we are still working on potty training. | ||||||
Play & exercise: |
We love to take walks and play ball/fetch in the back yard. We also love to let our dogs come with us to my husbands parents home in the country. They have a large fenced in yard where they can run and play all day. Our plan for the spring of 2020 is to portion off another large area of our yard (we live on 4 acres) with a chain link fence where our dogs can run as much as they want but still be safe. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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: |
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: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We own a home on 4 acres in town. Our house is set back far from the road, but our dogs are only allowed to roam our property on leashes or in our large 20×30 dog kennel. Our property only has structures (house and two garages) and the back area (3 acres) are all wooded. | ||||||
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? |
Megan Knowles | ||||||
Willing to train children? |
We do not have children and are not around them much, but we are very watchful and keep a close eye when our young nieces and nephews are around our dogs. If either the dog or the children act inappropriately with the other, one of them is always removed from the situation. | ||||||
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 definitely would try and resolve the problem. Our hopes is that our puppy would be able to meet the possible adoption beforehand to help make the determination. It is EXTREMELY important to us that the dogs are friendly at the very start. We actually won't consider adoption of a dog that our current puppy does not get along with. | ||||||
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} |