Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 05/01/2020 | 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: |
Black Headed Tri, Sable & White | Activity level: |
Playful, Energetic, Other (Please describe in the box below.) |
Other preferences: |
It's mostly my husband and I at home, we both love being outdoors, however our corgi had his dedicated walk time where he could sniff and stop as many times as he wanted, we never forced him to run or walk fast, unless he wanted to do it, because we know corgis can get hot easily. | ||||||
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? |
Roberto and Gloria | ||||||
Why do you want a Pembroke? |
We want to adopt a corgi because our experience with our previous one was so wonderful. We adopted our corgi and had him for twelve years – he was the center of attention for our family! We were looking for a small/medium sized dog who was intelligent and active, and that was exactly our experience. In addition to that, we found the breed to be incredibly caring and each member of our family found a special bond with him. We find that our lifestyle is a great match for this breed; we are a household of adults (my husband and I with frequent visits from our adult children) and we enjoy a lot of outdoor activity. | ||||||
Activities planned with Pembroke: |
I am a homemaker who values routine and outdoor activity. In addition to a regular walk 2-3 times a day in the neighborhood we enjoy going to the park on evenings and weekends. We would love to continue going to the dog park on a regular basis. We also enjoy quality time at home and would love a new addition to have "pack time" with in the evenings.
Something that we are also interested in doing is training she/he to be a service dog. This is something we've always wanted to do. |
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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? |
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 are almost certain it would not be. When we had our previous Pembroke he came to us at two years old after being in a puppy mill. He was malnourished, afraid, and aggressive. We found that with plenty of care and patience (training him, cleaning up after him, socializing him, activity, and positive reinforcement) he transformed into a healthy, loving dog. Our first course of action is always to consult our vet and other help. In the absolute worst case scenario in which we would not be able to tend to a new corgi, we would reach out to Lakeshore Rescue to help us. | ||||||
Discipline: |
Our family believes that long walks and activity can go a long way. In addition to that, we practice positive reinforcement — we we introduce a new form of behavior we show affection and reward with treats. | ||||||
Where would Pembroke spend the majority of the time: |
He or she would spend the majority of time with my husband and I in our home. We live in a four bedroom condo in a gated community with plenty of grassy areas and a lot of dog neighbors. We also live about five minutes from a hiking/running trail. | ||||||
Discipline: |
Our family believes that long walks and activity can go a long way. In addition to that, we practice positive reinforcement — we we introduce a new form of behavior we show affection and reward with treats. Where would Pembroke spend the majority of the time: He or she would spend the majority of time with my husband and I in our home. We live in a four bedroom condo in a gated community with plenty of grassy areas and a lot of dog neighbors. We also live about five minutes from a hiking/running trail. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, I am home full time and my husband is home in the afternoon or evenings (he has a 5 minute commute to work). | ||||||
Where would dog eat? |
We placed our previous dog's food at the wall of the kitchen. He ate twice a day at 7 a.m. and 5 p.m. before all of us and some treats throughout he day – a bone or peanut butter cone. We would have a similar set up in the future since we found it to work well. | ||||||
Where would dog sleep: |
In our bedroom. We like having the option of he or she sleeping in their own dog bed or with us in bed. There is plenty of room for everyone. | ||||||
Play & exercise: |
At the very least, one long walk of 30-60 minutes depending on the weather and age of the corgi. My husband goes to a walking/running trail 5-6 days a week, and I enjoy going with him to walk and would naturally want to take our corgi. We also believe in just sitting outside and enjoying the fresh air, so common areas in our neighborhood or a dog park would be nice to just let the corgi sniff and explore. | ||||||
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: |
|||||||
Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We live in a gated community with plenty of grass and a small deck, but no fenced in yard for just us. | ||||||
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? |
Gloria Lopez | ||||||
Willing to train children? |
Our children are 33, 32, and 30 and have all taken an active role in taking care of our pets in the past. They no longer live with us, but they visit often. | ||||||
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, definitely. We don't anticipate getting any additional pets, but if we were to we would test the compatibility of personalities. | ||||||
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} |