Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 08/02/2020 | 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, 5 years – 10 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: |
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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? |
Ourselves | ||||||
Why do you want a Pembroke? |
We want to adopt a Pembroke Welsh Corgi because we do love the breed and it's a non-negotiable that we adopt. We're drawn to the breed because of their cuteness, of course, but also their intelligence and temperament. We're very interested in how easily trained many tend to be and how loving they are. We really love that they're family dogs and are anxious to introduce one into our pack. | ||||||
Activities planned with Pembroke: |
We have a smaller fenced-in yard for short potty breaks, but take daily walks around the neighborhood. We live less than a block from a paved trail (the Monon) so walks there are a near daily activity and FULL of other dogs and lots to sniff. We also live about a 5 minute drive from a wonderful dog park. Finally, Liz's parents have a lake house, so trips up to the lake are commonplace in the summer–boat rides included if the dog is comfortable with them and with a life jacket (Tedi has one that makes her look like a clown fish). | ||||||
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 reprimand with firm "no" commands if we witness the dog misbehaving and redirect to the appropriate or desired outcome if possible. | ||||||
Discipline: |
We prefer positive reinforcement to negative | ||||||
Where would Pembroke spend the majority of the time: |
Our Corgi would spend all of his or her time in our house, except when out for adventures with us. We don't travel much, but when we do, we leave Tedi in the care of my parents, who have had dogs all their lives. | ||||||
Discipline: |
We prefer positive reinforcement to negative Where would Pembroke spend the majority of the time: Our Corgi would spend all of his or her time in our house, except when out for adventures with us. We don't travel much, but when we do, we leave Tedi in the care of my parents, who have had dogs all their lives. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
CJ works from home, so he's home all day. When he is called to the office, he goes in very early and is home very early, while Liz's schedule is more opposite, so our dog is alone for about half the day. | ||||||
Where would dog eat? |
Food and water are located in the kitchen. | ||||||
Where would dog sleep: |
Unless the dog preferred a crate or to sleep on a dog bed, the dog would sleep in bed with us. | ||||||
Play & exercise: |
Fortunately, because we live so close to the Monon Trail, there are ample opportunities to play, sniff, and walk/run. | ||||||
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 wooden picket fence surrounding our side yard that is approximately 5 feet tall. There are no gaps in the fence, and the previous occupant of the house was able to keep a Great Dane contained within it. | ||||||
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: |
Our yard is on the smaller side, but is perfect for a small pup like our Pomeranian or a Corgi. It's all grass, with the exception of a small brick-paved 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? |
Both Liz and CJ | ||||||
Willing to train children? |
We don't have any children and don't plan to | ||||||
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? |
Absolutely. We view this as a life-long commitment, so we'd try any and every in-home solution to any future problems. We think our family will be complete with the addition of a Corgi, so we don't anticipate adding any other pets. Our cat largely ignores the dog, and is generally pretty laid back. | ||||||
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} |