Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 07/11/2020 | 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, Very Active |
Other preferences: |
Must be good with cats and people, Cuddly/Affectionate | ||||||
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? |
Katherine | ||||||
Why do you want a Pembroke? |
I want to adopt a Pembroke Welsh Corgi because they have the heart of a large dog in a smaller body. After growing up in a household with large dogs all my life and only being allowed a 40 pound dog limit at my current residence, the Pembroke Welsh Corgi possess several characteristics that make it an ideal companion for current lifestyle, including their loyalty/devotion to their owners, obedience, athleticism, strong will, intelligence, and outgoing/friendly personality. Since I live a single/active lifestyle, I believe the Pembroke Welsh Corgi is the right dog breed for me that can grow as my life changes. I want to rescue a Corgi because I want to give my love and a second chance to one that needs it most 🙂 | ||||||
Activities planned with Pembroke: |
Walking on park and hiking tails, obedience training, and lounging/playing at home | ||||||
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? |
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: |
Depending on mistake, stop dog from doing behavior first by distracting/leading them away. Train Pembroke on correct behavior and reward when they do it correctly using treats and/or verbal/physical praise. | ||||||
Discipline: |
Spray bottle with water/noise can (ones for use on dogs), redirect dog using toys or lead dog into another area, put away in kennel or put in kitchen with gate closed for "time out," reward good behavior with treats, verbal praise, and/or physical affection | ||||||
Where would Pembroke spend the majority of the time: |
Stay on main floor of condo (avoid upstairs as much as possible by inserting gate) will be in main living room, sitting room, and kitchen | ||||||
Discipline: |
Spray bottle with water/noise can (ones for use on dogs), redirect dog using toys or lead dog into another area, put away in kennel or put in kitchen with gate closed for "time out," reward good behavior with treats, verbal praise, and/or physical affection Where would Pembroke spend the majority of the time: Stay on main floor of condo (avoid upstairs as much as possible by inserting gate) will be in main living room, sitting room, and kitchen |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
No; If recommended by rescue owner can arrange to go home for 10-20 minutes during lunch break to take dog outside | ||||||
Where would dog eat? |
In the kitchen, will have dedicated area not near trash can or food | ||||||
Where would dog sleep: |
In kennel to start off, when corgi settles into new environment allow corgi to sleep on couch/chair | ||||||
Play & exercise: |
Will walk dog 1 hour a day during weekday at a nearby park and between 1.5-2 hours on the weekends on hiking/walking trails. If dog wants to play post walk will play inside on main floor of condo, including tug of war, fetch, and other games | ||||||
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? |
|||||||
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: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
N/A only have back wooded patio | ||||||
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? |
Katherine | ||||||
Willing to train children? |
N/A no children and no one in my immediate family has no 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 | ||||||
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} |