Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/14/2020 | 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: |
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: |
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Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
An active, older, married couple, the applicants named above. We’ve always had at least one dog, but our 16 year old Husky/Dane passed away last October. Morgan is adjunct faculty in the Communication and Creative Arts department at Purdue University Northwest, Tony works freelance as a photographer, including for the Northwest Indiana Times. We are home a lot, take long walks daily, have a fenced yard, and would love to share it with a new dog. Morgan fell in love with Corgis when she lived in Wales for a short while. We feel we would like to adopt 2 dogs at this time, one elder and one younger. It would be great if one of them was a Corgi or Corgi mix! We would like to meet a Corgi who would like a new family that includes 3 cats (all rescues, all lived with our dog), some fish, and a couple of birds. |
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Why do you want a Pembroke? |
Inquisitiveness, outgoing personality, tenacity, loyalty, and independence all strike us very desirable traits in our human companions and we also admire it in our canine companions. Plus, animals that have a sense of humor, which it seems Corgis possess in a remarkable degree, are a source of great joy and wonder to us! | ||||||
Activities planned with Pembroke: |
Well, that depends on their age and temperament, but definitely we will pet them and play with them, ball toss, tug ball, frisbee, swimming, whatever they find enjoyable. We also provide toys for self-play. We are active, so if the dog is up for a daily walk or run, so are we. If they want to lounge on the couch, we’re down with that, as well. If they need obedience training, we will make that happen. | ||||||
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: |
Don’t give attention to misguided behavior, time outs in crate or on dog bed. Take away toys. Use a different tone of voice to disrupt/stop unwanted behavior. | ||||||
Discipline: |
Positive reinforcement: Reinforce wanted behaviors with verbal praise and/or ear rubs. If food motivated, treats in moderation. | ||||||
Where would Pembroke spend the majority of the time: |
With us. Usually in the house or outside with us taking walks and/or playing in the yard. If a good car rider, they can accompany on trips to parks, beaches, etc. | ||||||
Discipline: |
Positive reinforcement: Reinforce wanted behaviors with verbal praise and/or ear rubs. If food motivated, treats in moderation. Where would Pembroke spend the majority of the time: With us. Usually in the house or outside with us taking walks and/or playing in the yard. If a good car rider, they can accompany on trips to parks, beaches, etc. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. I teach one day a week, Tony is freelance and works intermittently during the week. The dog would be attended to pretty much 24/7 by us. If we both need to be away longer than 6 hours, we hire a dog walker. | ||||||
Where would dog eat? |
In the house. We have a split level and will probably feed the dog downstairs, as the cats eat upstairs. | ||||||
Where would dog sleep: |
In the house, in their crate, if they prefer that over a dog bed in our bedroom or another room. | ||||||
Play & exercise: |
As much exercise as required to keep them healthy and happy. We walk daily, run several times a week. We have a fenced yard they 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? |
4 ft. foot chain link around backyard, just under 1000 sq ft. | ||||||
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? |
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Lease allow dogs: |
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Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
We have a large unfenced front yard and a smaller fenced back yard. We live above on a river, which is on the other side of the 4 ft. chain link fence. We do not have an in-ground swimming pool. The yard is patio blocks, mulch, stone, and wood walkways, we gave up on trying to grow grass under oak trees with 2 dogs some years ago. | ||||||
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? |
Morgan and Tony | ||||||
Willing to train children? |
We do not have children or grandchildren. We have children visit from time to time, but all have their own animals and already show great respect for 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? |
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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? |
Yes, we have a lot of patience. | ||||||
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} |