Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 04/30/2020 | 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, Other (Please describe in the box below.) |
Other preferences: |
We have 2 indoor cats, tons of squirrels in the yard, we do live near the airport some times of day it does get loud, backyard is fenced. | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
both, Michael is home or working and the dog would be with him most of the time. Pam is currently unemployed but handles feeding and vet care, with all the morning and evening chores and cuddles | ||||||
Why do you want a Pembroke? |
I have friends that own Corgis, I like the big dog in a small body concept. I do not like yippy dogs. They are clowns and stubborn and sweet. I have previously owned Akitas so I am used to stubborn but trainable. | ||||||
Activities planned with Pembroke: |
hiking, walking, fetch, car rides. Mike goes to different jobsites everyday to always new adventures to experience. | ||||||
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 |
||||||
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: |
verbal correction, possible crate time out to remove from situation | ||||||
Discipline: |
verbal/leash-collar correction. I have done several training classes with dogs over the years, it depends on the dog what method to use. | ||||||
Where would Pembroke spend the majority of the time: |
with people. back yard does have access to a petdoor to inside area of the garage, but our dogs are crate trained as well and not left in the yard unattended. smaller corgi would be an indoor dog, Akitas had preferred to be outside where it was cooler. | ||||||
Discipline: |
verbal/leash-collar correction. I have done several training classes with dogs over the years, it depends on the dog what method to use. Where would Pembroke spend the majority of the time: with people. back yard does have access to a petdoor to inside area of the garage, but our dogs are crate trained as well and not left in the yard unattended. smaller corgi would be an indoor dog, Akitas had preferred to be outside where it was cooler. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
yes | ||||||
Where would dog eat? |
in the kitchen | ||||||
Where would dog sleep: |
crate or bed, crate would be near or in bedroom | ||||||
Play & exercise: |
tons of walks, toys, daily activity, time needed would depend on the dog | ||||||
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 foot chain link in the backyard, we also own invisible fence system, back fence is 8ft tall and borders airport property | ||||||
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? |
No | ||||||
Description of yard: |
my landlord is my father, 3 bedroom, 1 bath house with attached garage, backyard is fenced, front yard is not and extra property is not fenced, we live in a cul-de-sac in a subdivision, close to lots of walking dog friendly trails, and convenient to the vet. We both work locally. small deck and covered hot tub in the backyard, rest is grass | ||||||
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? |
Pam | ||||||
Willing to train children? |
no children currently in the house, both of our adult children were raised to respect all animals | ||||||
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} |