Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 02/25/2020 | 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: |
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: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
I will be living at my parent's house with other pets so they should be able to get along with cats and other dogs | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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 me 🙂 I have always enjoyed corgis and have done lots of research into them. I am graduating soon and will be able to support (time, attention, and funds) and give a loving home to a corgi. | ||||||
Why do you want a Pembroke? |
I want to adopt a corgi because I find them a very lovable breed of dogs. They are very happy, go-lucky dogs and always bring a smile to my face. I have grownup surrounded by dogs and my favorite was a corgi my family owned for 2 years. These dogs can always make me smile. I enjoy the big dog personality in a small package. I have done a lot of research into this breed because I want to give my future dog the best living situation I can. I have done research into diet, exercise, living style, training, and health problems that could arise. I also love the loyalty these dogs can provide. | ||||||
Activities planned with Pembroke: |
My Pembroke will be by my side as much as possible. I enjoy taking walks, running, and going for hikes, all of which they would join me for. I would like to be able to sit and cuddle with them after the day is ending. Furthermore, I enjoy camping and when I go they would come with me. I would also like for my Pembroke to be my companion and keep me company. They will help to create a home I enjoy going back to. | ||||||
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: |
I plan on using positive reinforcement with my Pembroke and when mistakes happen I will use the would "no" as a cue to stop that behavior. I will not hit, harm, yell, or scream at my corgi. After catching the act of negative behavior, I will tell them "no" and then redirect to a positive behavior, followed by a reward for that behavior. By using positive reinforcement, I hope to encourage the good behaviors I wish to see. | ||||||
Discipline: |
I will use positive reinforcement and redirection. Also I will spend lots of time and use patience to help with training. | ||||||
Where would Pembroke spend the majority of the time: |
Most of their time will be spent by my side. I would like to allow them to free roam my apartment in my parents house. I also plan on walking/running, as well as playing outside (not in extreme temperatures or weather), in order to give them adequate exercise. | ||||||
Discipline: |
I will use positive reinforcement and redirection. Also I will spend lots of time and use patience to help with training. Where would Pembroke spend the majority of the time: Most of their time will be spent by my side. I would like to allow them to free roam my apartment in my parents house. I also plan on walking/running, as well as playing outside (not in extreme temperatures or weather), in order to give them adequate exercise. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. I will be living with my parents and one of my sisters. I will be working 3-4 night shifts a week and will be home during the day to care for them. On nights that I am at work, I have already discussed with my mom and sister to help me care for my Pembroke. | ||||||
Where would dog eat? |
My corgi will have a designated place for their food and water in my kitchen. This will be where I feed them meals and store their food. I will also have a water bowl in the bathroom and one outside. | ||||||
Where would dog sleep: |
My corgi will sleep with me either in my bed or next to my bed in their own bed. I will give them both options and they may choose their preference. | ||||||
Play & exercise: |
I plan on running with my dog after I wake up and going for walks around mid day and before going to sleep. Walks will include a trip to the park in my neighborhood where they can run off-leash once they understand the come command. After walks, I plan on playing with them in the yard by throwing toys or just chasing each other around. Another chance for play they corgi will have is with my parent's dogs. Both are very friendly and love to play with other dogs. This will give my corgi an opportunity to socialize and run with someone faster than myself. They will get a minimum of an hour and a half of exercise each day. | ||||||
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? |
|||||||
Living arrangements: |
in home apartment of my parent’s house (entire finished basement) | ||||||
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 house has a decent sized yard that backs up to a small lake. There is a deck with two entrances, a back patio, and a small patio with a fire pit in the same part of the yard as the lake. Also, there is garden in the back that grows fruits, veggies, and herbs along with other smaller flower gardens around the house. There are a few trees that provide shade. There is also an electric fence surrounding the house but I don't plan on using this feature. | ||||||
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? |
Emily (Me) | ||||||
Willing to train children? |
yes | ||||||
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 | ||||||
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} |