Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 08/03/2020 | Referred by: | Other | ||
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: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active |
Other preferences: |
|||||||
Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
Ourselves/family | ||||||
Why do you want a Pembroke? |
Our corgi just crossed the rainbow bridge in March, and we think we are ready to welcome another friend into our home. Life just doesn't feel right without a corgi. I have been a part of many corgis' lives from their birth to crossing over. I have had corgis since I was in kindergarten as my parents showed and bred them. They were a part of the Lakeshore PWC Club in the 70s and 80s, and after my dad passed my mom got back into showing corgis. She passed in 2009, and the last corgi I had was one she had bred and shown. | ||||||
Activities planned with Pembroke: |
Camping, hiking, lazing around the house watching movies. | ||||||
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: |
What? Pembrokes don't make mistakes! Kidding. We have always found firm commands and redirection to appropriate behavior works best. We never hit our animals. | ||||||
Discipline: |
We have always had our dogs trained in basic obedience. This has proven effective for us. | ||||||
Where would Pembroke spend the majority of the time: |
In the house with the family. If we were outside, the corgi would also be out with us. | ||||||
Discipline: |
We have always had our dogs trained in basic obedience. This has proven effective for us. Where would Pembroke spend the majority of the time: In the house with the family. If we were outside, the corgi would also be out with us. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, Amy works as a massage therapist, not usually starting the day until 11am. Mike comes home from work at 3. In between, our adult son is at home, as well our 17 year old will be home frequently due to distant learning. | ||||||
Where would dog eat? |
Our last corgi was slightly food aggressive, so she ate in her crate to avoid any issues. We have also fed our animals in the kitchen. We do not believe in letting our dogs eat at will as this has led to obesity in the past. | ||||||
Where would dog sleep: |
Either in the room with us in a pet bed, or if the corgi was mischievous at night, in a crate. | ||||||
Play & exercise: |
We have a full fenced in yard and will take the corgi to the dog park or on walks. | ||||||
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? |
Six foot privacy fence all around full size backyard. | ||||||
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: |
Full size back yard. No swimming pools or hot tubs. | ||||||
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? |
Amy Brown Gaghagen | ||||||
Willing to train children? |
Our children are mostly grown and have been raised to properly care for all animals. | ||||||
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? |
Aside from the last 4 months, our cat has always had dogs to live with in the house. He generally ignores them or leaves them alone. I don't foresee any issues, however on the off chance something should arise, we will definitely do whatever we need to in order to resolve 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} |