Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 06/23/2020 | 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: |
Couch Potato, Outgoing, Playful |
Other preferences: |
|||||||
Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
Soumith (Me) | ||||||
Why do you want a Pembroke? |
I want to adopt one because they are one of the most beautiful breeds of dogs. All my experiences with other owners' corgis in the past have been very good as they are super friendly and seemed well trained. I love that the Pembroke is an intelligent breed because it means that they are more easily trained. I love that they are super fluffy and I love browsing pictures of corgis in my spare time because I simply think they're some of the cutest dogs. I understand that they have herding and bossy behavior but that does not turn me away from them as I feel that I would be able to have a soft but stern voice with my Pembroke. | ||||||
Activities planned with Pembroke: |
I would take it on walks and runs around the neighborhood. Ideally my Pembroke would be by my side wherever I go, whether it be just around the neighborhood or on drives. It would never be alone. I love going to the park and to the local beaches so I would love to take my Pembroke there as well. | ||||||
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? |
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: |
I would try my best to show it the right thing to do. Pembrokes are intelligent so I believe that they will be able to learn from their mistakes. I would train it to know what's right and what's not and if the behavior is repetitive I would enroll in a class to train it. | ||||||
Discipline: |
I would guide the dog to show it what's acceptable and what's not. Or I would try not to feed into its excitement by not responding right away or react overtly. If these techniques don't work I would consult a trainer to see the best course of action to take. | ||||||
Where would Pembroke spend the majority of the time: |
It would be within the house property, inside most of the time except for walks and exercising. | ||||||
Discipline: |
I would guide the dog to show it what's acceptable and what's not. Or I would try not to feed into its excitement by not responding right away or react overtly. If these techniques don't work I would consult a trainer to see the best course of action to take. Where would Pembroke spend the majority of the time: It would be within the house property, inside most of the time except for walks and exercising. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes | ||||||
Where would dog eat? |
Inside the house, near the kitchen | ||||||
Where would dog sleep: |
In my room on a dog bed, or a pen if the it's not fully trained yet | ||||||
Play & exercise: |
I would take it with me on walks or runs around the neighborhood. There are quite a few parks in the area for the corgi to get its exercise as well. The corgi will get lots of opportunity to play and exercise as I am a very active individual and love being outdoors myself. | ||||||
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? |
|||||||
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? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We have a yard semi contained by small shrubs with a stone patio leading down to the 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? |
Soumith | ||||||
Willing to train children? |
There are no children in the household | ||||||
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? |
|||||||
Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
Not applicable as we don't have any other pets. But if we do get more pets in the future, which we aren't planning to, I am willing to try to resolve any problems | ||||||
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} |