Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 05/28/2020 | 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: |
Male | Color preferred: |
Any color | Activity level: |
Other (Please describe in the box below.) |
Other preferences: |
We live in town in Fargo, ND. We also live at our lake place year round on the weekends. (Plenty of room to roam) And our daughter lives on a ranch in north central ND – the dogs enjoy their time there too. |
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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? |
Our family – husband and wife | ||||||
Why do you want a Pembroke? |
We have always had Corgis. We understand them. They need to be mentally and physically challenged, and they need to know they are not the top dog.
We have typically been the home for Corgis who can no longer stay with their owners. On a few occasions we have raised the dogs from puppyhood, including the two who are with us now. |
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Activities planned with Pembroke: |
Our dogs are members of our family. They ride in the car with us, go on walks, watch tv, ride in the boat, hang out outside, play fetch, work on obedience, visit family and friends. | ||||||
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: |
Get their attention, help them do it right and praise them. | ||||||
Discipline: |
Low voice, shtttt sound, poke them in the neck, "watch me", get them to focus, retry.
If they jump up, dip down and use your knee to block them. You must never hit a Corgi or you will ruin them. |
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Where would Pembroke spend the majority of the time: |
Inside the house, with us or outside. Our dogs are occasionally kenneled, but not for extensive periods of time. I work from home. | ||||||
Discipline: |
Low voice, shtttt sound, poke them in the neck, "watch me", get them to focus, retry.
If they jump up, dip down and use your knee to block them. You must never hit a Corgi or you will ruin them. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes | ||||||
Where would dog eat? |
We have food dishes in the kitchen for the two 2 year olds. Our old girl ate in another area of the living room. The Corgis wait until invited to eat. If there needs to be separation, we'll do it. |
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Where would dog sleep: |
The dog would sleep with us on our bed or on the floor. We have one kennel in the bedroom that one of the dogs prefers instead of the bed. We also have dog beds on the floor and another kennel in another bedroom so they are separated while kenneled (because they are litter mates) | ||||||
Play & exercise: |
Daily walks am/pm. Fetch (not all do, but the two we now have love it) and training sessions each day. | ||||||
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: |
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: |
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Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We live in town for several days of the week. We also have a lake home where we go for the remainder. The dogs are each on a long leash when they are outside with or without us. Our old dogs would stay around the lake house. The two we have now like to roam so we will be installing an invisible fence at the lake. We have a boat and a dock and the dogs will go on the boat with us. |
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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? |
Both Mark & Pam | ||||||
Willing to train children? |
Yes – We have grandchildren who have pets and are respectful of them. Our daughter is a dog trainer and the children all are learning, too. |
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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 we are.
The right dog will show up who needs a home with us and we will make sure they are all safe and respectful of each other. |
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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} |