Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 12/06/2019 | Referred by: | Website, Other | ||
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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active, Other (Please describe in the box below.) |
Other preferences: |
We do have a corgi already. The dog would need to be able to coexist with Olive, and hopefully become good friends. We also have a teenage son (16). He is probably the person Olive is most attached to, and has always been mindful of treating our dogs well. | ||||||
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? |
Our family. We currently have a 2 1/2 year old corgi (Olive). Her companion, Annie a 14 year old beagle, passed away recently. We would love a second corgi for our home, and to keep Olive company. | ||||||
Why do you want a Pembroke? |
We love our current corgi Olive, and her energy. She has a stubborn streak, and is very clever. She is so cute we can't stand it. | ||||||
Activities planned with Pembroke: |
We live in the country in SE Michigan, on 10 acres. We have 1.5 acres fenced for the dogs to run in . We have mowed trails in the remainder of our property to walk the dogs on when we don't want travel for an extensive walk. We would also bring the dog with us for outdoor event, and for shopping at stores that allow dogs. We camp a few times a year, and the dogs come with us. |
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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 only correct her for things we see her do. Usually, a firm "No" is all we do. | ||||||
Discipline: |
See above. | ||||||
Where would Pembroke spend the majority of the time: |
We have a doggy door. The dogs tend to spend a lot of their time in the yard, but always have access to come in. Probably about 50-50 between indoors and outdoors during the day if the weather is nice. | ||||||
Discipline: |
See above. Where would Pembroke spend the majority of the time: We have a doggy door. The dogs tend to spend a lot of their time in the yard, but always have access to come in. Probably about 50-50 between indoors and outdoors during the day if the weather is nice. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No. My wife and I both work, and our son is in High School. We would plan a period of two weeks (using vacation time) to have at least one of us home at all times when we first get a new dog. This way, we can supervise the integration of a new dog into our home. | ||||||
Where would dog eat? |
We separate our dogs for meals. This ensures each dog gets the correct amount of food, and reduces potential confrontation. We have two locations in the house where we typically feed each dog. | ||||||
Where would dog sleep: |
We have dog beds in a couple locations in the house, including two in our bedroom. We also have a large crate with a dog bed in it, but none of our dogs seem to want to use it. | ||||||
Play & exercise: |
Our adopted corgi will be a family member and exercise each day. Currently, the neighbor has two dogs also, and they like to run up and down the fence line together, barking excitedly. We usually walk Olive (our corgi) at least once a day for a mile or so. | ||||||
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? |
We have a 4 foot tall fence made of "horse fence" material. There is about 1 1/2 acres of fenced yard. The fence is quite secure. The beagle was an escape artist. We had to keep the fence up diligently to keep her from getting out. | ||||||
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: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
The fenced yard is about 1 1/2 acres. There is an above ground swimming pool with a ladder that our existing dogs have never been able to climb. There is a solar panel array (that should pose no hazard to dogs or people). There is an outbuilding, and some raised garden beds.. Mostly just grass. | ||||||
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? |
Lynda Roberts | ||||||
Willing to train children? |
Yes. Gabriel (our 16 year old) has had dogs in the home his whole life. | ||||||
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. But it would be nice for us (including Olive) to meet a potential adoption candidate before the new dog enters our home. | ||||||
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} |