Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 04/15/2020 | 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: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful |
Other preferences: |
The Pembroke would be my (Sarah) emotional support animal (ESA). I would like to adopt the Pembroke in July, as I am moving and would like to be settled before adopting.
The dog must be crate trained and house broken. |
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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? |
The Pembroke is for Sarah Spears. Sarah would like to adopt the Pembroke to be a companion and to serve as an emotional support animal (ESA). Ideally, Sarah would like a dog that is 1-3 years old. | ||||||
Why do you want a Pembroke? |
I would like to adopt a Pembroke because I believe they are the best breed for me at this point in my life. I am young and am an active individual. Pembrokes are very active and intelligent dogs, so my activity level would match the level of the dog. I am looking for a companion and emotional support animal. Pembrokes are very loyal to their owners & enjoy human companionship. This would be ideal for me. I want a companion that matches my activity level and need for companionship and comfort.
While I do not have any personal experience owning a Pembroke, I have friends and relatives who have owned them. I have experience owning small- medium size dogs as my family has had dachshunds ever since I was born and Britney spaniels. I have done my research on Pembrokes and have read many articles from the American Kennel Club (AKC). I understand the challenges and responsibilities that come with owning this breed of dog. |
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Activities planned with Pembroke: |
Purdue University and West Lafayette provides a great environment for a dog! There is a local dog park (Shamrock Dog Park), the Purdue Horticulture Park, Happy Hollow Park & a local State Park to take the dog to for exercise. I am an avid walker and hiker & would love a dog companion for my walks around the neighborhood and in the park. I walk for at least an hour and a half per day.
Pembrokes are very smart animals. It is best to stimulate their intelligence by providing training & teaching them new skills. I would like to train my Pembroke (if possible) to engage in activities such as fetching and running. In addition, the Purdue Veterinary School & Animal Hospital is several blocks away from my house. This community is world renown in its care and knowledge of animals. This would be a fantastic resource for information, guidance and health related information and services for my dog. |
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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 would handle the mistake with grace. It is not the dog's fault for making a mistake. I would first try to understand why the mistake was made, and work on correcting the behavior rather than punishing the behavior or mistake. | ||||||
Discipline: |
I think that basic obedience is important with a dog. I would teach it to use its crate or kennel. I would use positive reinforcement to reinforce behaviors that are appropriate. I would reward behaviors that are ideal and appropriate with small treats or praise. Pembrokes respond well to treats, as they are very food motivated. Another way of disciplining the dog is by being clear and consistent with expectations to avoid confusion. I would NEVER discipline the dog by being mean, harsh or abusive. |
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Where would Pembroke spend the majority of the time: |
The Pembroke would spend most of his or her time with me! While I have around 4 hours of classes per day, most of my time would be spend at home with my Pembroke. I would take the Pembroke for walks and enjoy the local neighborhood and environment around us. I would treat the Pembroke more like a family member than a pet. | ||||||
Discipline: |
I think that basic obedience is important with a dog. I would teach it to use its crate or kennel. I would use positive reinforcement to reinforce behaviors that are appropriate. I would reward behaviors that are ideal and appropriate with small treats or praise. Pembrokes respond well to treats, as they are very food motivated. Another way of disciplining the dog is by being clear and consistent with expectations to avoid confusion. I would NEVER discipline the dog by being mean, harsh or abusive. Where would Pembroke spend the majority of the time: The Pembroke would spend most of his or her time with me! While I have around 4 hours of classes per day, most of my time would be spend at home with my Pembroke. I would take the Pembroke for walks and enjoy the local neighborhood and environment around us. I would treat the Pembroke more like a family member than a pet. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No. I am the only person to live at my place of living. Occasionally, my partner will come over and hang out. | ||||||
Where would dog eat? |
The corgi will eat inside of my house. The food will be located in a bowl in the kitchen of my home. The corgi would eat food based on its age, gender, and other health requirements. I would select a food that is recommended by my veterinarian and stick to the same brand of food for my corgi. | ||||||
Where would dog sleep: |
My adopted corgi will sleep wherever it wants to inside of my house. It can sleep with me in my bed, in its Kennel, on the couch or on a dog bed. | ||||||
Play & exercise: |
I am a young and active person. I enjoy walking, hiking and running. My partner and I walk for at least an hour and a half per day. I would be taking the corgi out on walks and to local parks and green spaces to run and play. The corgi will get several hours of exercise and play time per day. Purdue University and West Lafayette have SO many public parks, dog parks, green spaces and State Parks that I can take the corgi. I enjoy going out into the outdoors and hope to share this with my pet. If the corgi is interested in being around cattle (as they are herding dogs), I know several farmers with cattle that I can bring the corgi around. | ||||||
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? |
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Living arrangements: |
Employer provided apartment in University Residences | ||||||
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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
The corgi would be my ESA (emotional support animal). I have the paperwork given to me by my physician and the Purdue University Disability Resource Center. My landlord MUST provide accommodations to allow me to bring my corgi.
Across the street from my building is a very large recreational sports field and park. This would be an ideal location for taking the corgi for walks and for playtime. |
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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? |
Sarah Spears | ||||||
Willing to train children? |
We do not have any children at this time. If we do decide to have children within the next 10 years we will teach our child how to humanely care for animals. We both grew up with pets and fully understand the responsibility of owning and caring for a pet. We understand that children may not understand how to respect a pet, and would like to teach our future child the importance of animal care. | ||||||
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? |
If we decide to get another pet, we will slowly introduce the new pet to the adopted Pembroke. If they do not get along, we will try to figure out the reason why (food aggression, protective of space etc..) and accommodate for the needs of the Pembroke. We may talk to an animal behavior specialist to get the issue resolved. | ||||||
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} |