Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 05/07/2020 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 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, Energetic, Very Active |
Other preferences: |
We are willing to work with any type of personality. We just need to ensure the new friend gets along with other dogs. | ||||||
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? |
We have been wanting to adopt a second dog after we adopted our spoiled boy Bowie. He is very social and enjoys the company of other dogs. We had to wait until we had enough space for two dogs. We have recently moved into our first home and we are now ready to shower our love on a little cutie in need of a new home. | ||||||
Why do you want a Pembroke? |
I have grown up with larger dogs most of my childhood. I have without a doubt adored each dog, but I am ready to share some love with a smaller breed. The energy levels of corgi would match well with our current blue heeler mix. We have watched a variety of dogs for friends and family and fell in love with the demeanor and snuggability of the corgi breed. We have looked into some of the possible health issues that could arise with owning a corgi. | ||||||
Activities planned with Pembroke: |
We are active with our current dog with daily walks and hikes on the weekend. We live near a variety of trails and paths. We love visiting our furry relatives and staying social at the dog park. We also leave time for cuddles on the couch and play in the yard. | ||||||
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: |
We are strong believers in positive reinforcement. All of the training classes we have done follow this method. We like to catch them doing something good and reward. Ignore negative behavior. | ||||||
Discipline: |
We like to catch them doing something good and reward. Ignore negative behavior. We also know practice is key to maintaining good behavior. | ||||||
Where would Pembroke spend the majority of the time: |
Our current dog has full run of the house. It took some training to get here, which would be the same for our corgi. With our new home, we have more spaces to gate off during training periods if we were to leave the home for a short period of time. | ||||||
Discipline: |
We like to catch them doing something good and reward. Ignore negative behavior. We also know practice is key to maintaining good behavior. Where would Pembroke spend the majority of the time: Our current dog has full run of the house. It took some training to get here, which would be the same for our corgi. With our new home, we have more spaces to gate off during training periods if we were to leave the home for a short period of time. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I work as a teacher, and make sure to come home during my lunch break each day. We would hire a dog walker if needed. My husband has varied work hours. | ||||||
Where would dog eat? |
We have a space for feeding near the kitchen. | ||||||
Where would dog sleep: |
Our current dog only sleeps with us. We would keep the corgi in the room with us and once trained let them decide the best spot; couch, bed, dog bed, or spare bed. We don't mind. | ||||||
Play & exercise: |
We try to keep our current dog very active. We take daily walks, visit the dog park, visit and play with family/friend dogs, and take hikes. | ||||||
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 tall privacy wooden fence covering the entire yard. We do not own a pool, so there is plenty of space. | ||||||
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 have a tall fence that encloses our yard. The yard is free of obstructions. We do not own a pool. | ||||||
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? |
Kayleigh Gyure | ||||||
Willing to train children? |
We do not have children, and do not plan to have children. | ||||||
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, we will work towards resolving the issue. | ||||||
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} |