Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 02/16/2020 | Referred by: | Website, Friend, Breeder | ||
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: |
Red & White, Sable & White, Any color | Activity level: |
Outgoing, Quiet, Playful |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
My husband and I are both in age 30. My husband is finishing his phD at University of Chicago and I am currently working as a sensory scientist at Mars Wrigley located in Chicago.
I'm looking for in a corgi and they have been my dream dog and they are a perfect size dog. My husband and I had done many research about Corgi before deciding that we are ready to have our first Corgi. We will be first time dog parents. We are both animal lovers and we grew up with dogs in our lives. They are our family and best friends ❤️ We would like to provide a loving home to a rescue Corgi. |
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Why do you want a Pembroke? |
Corgi has always been my dream dog. We are currently living in 2 bedrooms apartment and Corgi is a perfect size dog. We did all the research about the dog and their personalities and Corgi seems to be a perfect fit for me and my husband. | ||||||
Activities planned with Pembroke: |
there are plenty of activities that I'm prepared for with my corgi. Taking him/her to the dog park if Chicago weather allows, go for a walk, go to the dog beach, explore many parks in the city, go for road trips, go hiking together, teach him/her new and cool tricks, etc. | ||||||
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? |
No | ||||||
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: |
I will make sure to correct the mistake at the moment so the dog knows that is a NO! NO! situation and redirect him in other way with more appropriate behavior. | ||||||
Discipline: |
I would use positive reinforcement for good behaviours, and will set rules and boundary with the dog in the early stage of training as well as spending more time and be patient with the dog. | ||||||
Where would Pembroke spend the majority of the time: |
He/She will be staying in the 2 bedrooms apartment with us. | ||||||
Discipline: |
I would use positive reinforcement for good behaviours, and will set rules and boundary with the dog in the early stage of training as well as spending more time and be patient with the dog. Where would Pembroke spend the majority of the time: He/She will be staying in the 2 bedrooms apartment with us. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. My husband will be home most of the time. He may be gone for 1-2 hours/daily for his classes but he is around. I usually work from 9 am – 5 pm but in case when both of us are gone, we will find a dog walker or our friends to look after the dog. | ||||||
Where would dog eat? |
We live in an apartment so he will eat together with us. I would like to set up an area in the kitchen for his food bowl so its easier to clean up 🙂 | ||||||
Where would dog sleep: |
He/She will have his own bed and he can sleep anyplace with his choice or sleep with us in our bedroom. | ||||||
Play & exercise: |
we will make sure our dog gets enough exercise and activities to stay healthy. We are both active people. For now, I am thinking we would walk the dog twice a day early in the morning and one in the evening so the dog can be outside and stay healthy. Will let him out for short time in the mid day to go potty. | ||||||
How will you exercise your dog? |
On leash | ||||||
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: |
Rent/lease 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? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
We are located in the city so we dont have a yard or swimming pool but we live near by a park. | ||||||
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? |
Ngoc & Tung Le | ||||||
Willing to train children? |
yes. We currently dont have any kids yet but if we do, we will teach our kids how to probably treat our pets. | ||||||
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? |
We currently dont have any pets. | ||||||
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} |