Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 01/28/2020 | 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, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Black Headed Tri, Any color | Activity level: |
Couch Potato, Outgoing, Playful, Energetic |
Other preferences: |
Just looking for a corgi that we will enjoy and he or she will enjoy being with a family that loves him. | ||||||
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? |
Myself and my older children,,17, 16. 11. I have lived in same home for 18 years, fenced in large yard to play. Had a brussel griffen that i adopted from west michigan humane society about 6 years ago but he was already 10 years old when we got her. She passed away a year n half ago. We are now looking to give a corgi a forever home. | ||||||
Why do you want a Pembroke? |
I have no experience with a corgi. We have watched many videos of corgis, people who own corgis and all about corgis. House is filled with corgi decor but real corgi lol. We had a brussel griffin that we adored but she has passed from old agr. Although we love that breed, we would like a different breed this time and a corgi is what we have been researching for a while and are excited to finally be ready to start looking for one. | ||||||
Activities planned with Pembroke: |
He would mostely be an inside dog, walks for potty, and enjoy outside with us on nice days. | ||||||
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 |
||||||
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: |
Tell him no | ||||||
Discipline: |
I tell them no and remove them from the situation. Depending on what it was. If they are getting in the trash can, i would stand infront of the trash n tell them no. Eventually they will understand when there access to what they want is blocked and they understand the word no. Until then its just repetitive training. | ||||||
Where would Pembroke spend the majority of the time: |
In the house. My brussel griffin was always allowed anywhere in the home without restriction. Although she mostly just wanted to be wherever we were. | ||||||
Discipline: |
I tell them no and remove them from the situation. Depending on what it was. If they are getting in the trash can, i would stand infront of the trash n tell them no. Eventually they will understand when there access to what they want is blocked and they understand the word no. Until then its just repetitive training. Where would Pembroke spend the majority of the time: In the house. My brussel griffin was always allowed anywhere in the home without restriction. Although she mostly just wanted to be wherever we were. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, someone is at home all day. | ||||||
Where would dog eat? |
In the kitchen is where i had previously kept our other dogs food bowls. | ||||||
Where would dog sleep: |
If he chooses to sleep on the floor, or if he chooses to sleep in the bed, either is ok. | ||||||
Play & exercise: |
I have a large fenced in yard he can play in. | ||||||
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? |
I have a tall wooden that surrounds the property. | ||||||
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: |
I have a playhouse, a trampoline, and a large playstucture in my yard. The rest is open area to run. | ||||||
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? |
Anita | ||||||
Willing to train children? |
Yes, all my children are old enough and have cared for a dog before. | ||||||
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? |
|||||||
Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
Yes, although i do not have any plans on having more. | ||||||
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} |