Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 01/04/2020 | Referred by: | 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: |
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: |
We have an active 8 month old tri colored corgi puppy so we are looking for a corgi who gets along well with other dogs. | ||||||
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? |
Us (2 adults, no children) | ||||||
Why do you want a Pembroke? |
I grew up with a pembroke Welsh corgi (Sophie) and also rescued a pembroke Welsh corgi in 2012 whose name was Charlie. He passed away in 2018 from an inoperable brain tumor and after a few months I was ready to get another dog which is when we got Banjo, our 8 month old corgi. We are absolutely in love with the breed because of their amazing, big personalities. Having owned 3 corgis before I feel that I understand the breed well and what their needs are. | ||||||
Activities planned with Pembroke: |
I have a large fenced in backyard where we play with our corgi and we also live in a very walkable neighbor close to a dog park where we like to bring Banjo. We also attend various corgi meet ups throughout the year in Grand Rapids. Trevor and I work from home regularly throughout the week so we are home with Banjo a lot and take him for frequent walks which he loves. | ||||||
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 use simple cues and 1 word (“eh-eh”) to let Banjo know when we don’t like something he is doing (jumping up on people when they walk in the door, etc). We find this helps so he doesn’t get confused if we try too many different methods/words. We do not use any sort of physical punishment (swatting, rubbing his nose in an accident when he was being house trained, etc) | ||||||
Discipline: |
Never physical, only verbal cues or hand cues. We believe it is important to keep commands simple. | ||||||
Where would Pembroke spend the majority of the time: |
We work from home pretty regularly so now that Banjo is house trained he basically has the run of the house when we are home but we always keep him near us because he is still a puppy and we know he can still get curious and get into things. When we leave he goes in his crate or we take him with us whenever safe/possible. The same would go fo another Pembroke in our home. | ||||||
Discipline: |
Never physical, only verbal cues or hand cues. We believe it is important to keep commands simple. Where would Pembroke spend the majority of the time: We work from home pretty regularly so now that Banjo is house trained he basically has the run of the house when we are home but we always keep him near us because he is still a puppy and we know he can still get curious and get into things. When we leave he goes in his crate or we take him with us whenever safe/possible. The same would go fo another Pembroke in our home. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. The longest we have ever left Banjo home alone (in his crate) has been 4 hours. | ||||||
Where would dog eat? |
We keep dishes in the kitchen, but we measure out the food twice per day. We would keep their dishes separate from each other in the kitchen. | ||||||
Where would dog sleep: |
Banjo has a bed next to our bed and we have stairs he can use if he wants to come sleep next to us at all during the night. We keep our bedroom door closed so he stays near us all night. | ||||||
Play & exercise: |
Or corgi, Banjo, LOVES other dogs and would love to have another dog to play with. We also have a large fenced in backyard with a lot of room to run. We live in a neighborhood with many places to walk, including a dog park just 2-3 blocks away. | ||||||
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 chain link fence that surrounds my entire backyard. I am happy to provide photos if requested. | ||||||
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? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We live at the end of a cul-de-sac so I have a large wedge shaped yard that spans 3 lots. We do not have a swimming pool or any other fixtures that would be hazardous to animals. | ||||||
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? |
Laura Porter | ||||||
Willing to train children? |
We do not have children and do not intend to ever have them. | ||||||
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? |
Of course | ||||||
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} |