Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/09/2020 | Referred by: | Friend | ||
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, 5 years – 10 years, 10 years + | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Energetic |
Other preferences: |
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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? |
The dog would be a parter and best friend. | ||||||
Why do you want a Pembroke? |
Growing up I had two corgis. Their temperament and personalities filled me with so much joy. I love their spunky attitudes and that they are “big dogs in a little body”. They are very intelligent dogs and I want one because I know they will be compatible with my current living situation. | ||||||
Activities planned with Pembroke: |
We want walk the corgi often. We would take it to the lake, walk it down the river and take it to the park to play. We would play with the dog in the house often and would make sure it received lots of exercise. | ||||||
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: |
We would be very patient. We would show the dog what it did improperly but then refocus it to a good behavior. We would guide it from negative behavior to positive behaviors by using clear commands and food incentives to correct mistakes. | ||||||
Discipline: |
We would calmly let the dog know what he did wrong and show him specifically what it is that he did inappropriately. We would look away and ignore him when he’s acted out just for attention. After ignoring him we would immediately give him attention again when he begins behaving well. We would crate him for only short times to let him know when he’s acted poorly but once he’s learned a quick lesson we would let him out again. | ||||||
Where would Pembroke spend the majority of the time: |
In our apartment with us, out and about. It would also spend much of its time outside, going for walks. | ||||||
Discipline: |
We would calmly let the dog know what he did wrong and show him specifically what it is that he did inappropriately. We would look away and ignore him when he’s acted out just for attention. After ignoring him we would immediately give him attention again when he begins behaving well. We would crate him for only short times to let him know when he’s acted poorly but once he’s learned a quick lesson we would let him out again. Where would Pembroke spend the majority of the time: In our apartment with us, out and about. It would also spend much of its time outside, going for walks. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Most of the day their our people home. I work very early and by the time I come home my girlfriend has only been gone for a few hours. There is almost always someone home. | ||||||
Where would dog eat? |
The adopted corgi would eat in our kitchen. We have fostered dogs and already have a designated area for this. | ||||||
Where would dog sleep: |
We would have the dog sleep in the living room at first but eventually would give him a dog bed in our room. | ||||||
Play & exercise: |
He will exercise daily and visit the park every weekend. We will walk him around the neighborhood, down the river walk and often to the nearby parks. | ||||||
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? |
Not applicable | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
We don’t. | ||||||
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? |
Gabriel Barnett and AshleyGrace Jose | ||||||
Willing to train children? |
We don’t have any children and don’t intend to have any. | ||||||
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? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
We don’t have current pets and don’t plan to have multiple pets. If we do then we will resolve the issue. | ||||||
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} |