Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 05/06/2020 | 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: |
Outgoing, Playful, Energetic |
Other preferences: |
Must get along with other dogs. We have two rescue dogs one is and old girl who is sweet and the other is a 3 year old small dog who loves to play. | ||||||
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? |
Our family, me (lisa) husband (mike) and son 16yrs (nate) | ||||||
Why do you want a Pembroke? |
I love the breed and have always wanted a Corgi. We have several Corgis in the neighborhood and I just love their personalities, I am very familiar with the breed and have done plenty of research. I am a firm believer in rescuing dogs and have rescued 3 in my adult life. It's the best way to get a wonderful dog and give them a forever home that is loving and caring. | ||||||
Activities planned with Pembroke: |
We have a fenced in backyard for playing fetch and running with our other dogs. We also live 2 min from a nature conservancy so we walk with our dogs a lot. The Corgi would get plenty of exercise and play time. I would also like a dog who will snuggle with me when it's downtime. | ||||||
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: |
Firm "NO" Spend time training to work on negative behavior with positive reinforcement. | ||||||
Discipline: |
This is a tough one because I have never had to discipline a dog, other than telling them NO and redirecting the behavior. i.e. "leave it" or "quiet", etc. I do not believe in punishment or isolation for a dog. | ||||||
Where would Pembroke spend the majority of the time: |
In our home. | ||||||
Discipline: |
This is a tough one because I have never had to discipline a dog, other than telling them NO and redirecting the behavior. i.e. "leave it" or "quiet", etc. I do not believe in punishment or isolation for a dog. Where would Pembroke spend the majority of the time: In our home. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. I work 3.5 days/week. Currently we are all at home due to COVID 19. I have a son who gets home from school at 3:45 during the school year and lets the dogs out ASAP when he gets home. Sometimes my husband works from home if he doesn't have meetings. So to answer the question, there's someone home for part of the work week. | ||||||
Where would dog eat? |
Kitchen. I hear they can be somewhat territorial with their food, so having a quiet place to eat without distractions is what I would provide | ||||||
Where would dog sleep: |
On a doggie bed in the mudroom until trusted to sleep on second floor with family. | ||||||
Play & exercise: |
see answer about fenced in yard an walks in nature conservancy | ||||||
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? |
We have a cedar fenced in yard that has access from the house and a gate that goes to the garage. | ||||||
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: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We live on a corner lot with a fenced in yard. We do not have a swimming pool. We have small trees and stone landscaping. | ||||||
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? |
Lisa White | ||||||
Willing to train children? |
Yes, My son has been around a family dog since he was born. He currently helps with our current dogs by feeding in the AM and walks. He plays with them and gives them plenty of love and attention!! | ||||||
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} |