Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 08/06/2020 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 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 |
Other preferences: |
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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? |
For myself | ||||||
Why do you want a Pembroke? |
I have a close friend who has a Pembroke Welsh Corgi named Magnolia (Mags!). I have spent a lot of time with her over the years, including looking after her when her owners go out of town. What I love about the breed is how smart and loyal they are. Mags isn't as affectionate as I have heard most Pembroke Welsh Corgi's are but I love how sociable she is and how she is always right there when you are doing something around the house – just checking in on you! She made me fall in love with Pembroke Welsh Corgi's for their independent, fun loving nature. | ||||||
Activities planned with Pembroke: |
I love to walk and would love company on my walks. I'd take them to the park and throw a ball around, visit friend and of course cuddle on the couch. | ||||||
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? |
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: |
If the Pembroke makes a mistake I would walk over to him/her and firmly but calmly say 'no' and take him her outside or to a pee pad. I'd then reward him/her vocally when they go in the right place | ||||||
Discipline: |
I would work to train the dog with basic commands 'sit' 'stay' 'heel' etc. I'd ensure repetition and ideally daily in house training to make sure commands are followed. From my experience staying calm at all times is vital and also ensuring patience while he/she learns. | ||||||
Where would Pembroke spend the majority of the time: |
My Pembroke would spend most of his/her time in my apartment with me! | ||||||
Discipline: |
I would work to train the dog with basic commands 'sit' 'stay' 'heel' etc. I'd ensure repetition and ideally daily in house training to make sure commands are followed. From my experience staying calm at all times is vital and also ensuring patience while he/she learns. Where would Pembroke spend the majority of the time: My Pembroke would spend most of his/her time in my apartment with me! |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
At the moment yes I am home all the time. I do work in an office environment and it's still unclear if/when we will go back. If I do go back to the office I would have a dog walker come in to walk my Pembroke during the day | ||||||
Where would dog eat? |
My Corgi would eat in my apartment. When I look after friends dogs I usually put water and food down in the kitchen | ||||||
Where would dog sleep: |
My adopted Corgi would ideally sleep in a dog bed in my room. Again to begin with I recognize they may need to be in a crate while they get used to the space but would want them to end up with some space to move around in the night if they want to. | ||||||
Play & exercise: |
I am a pretty active person. I love to walk so 'd look to take my Corgi out on walks 3 – 4 times a day and of course be sure to visit the park and throw the ball to them. | ||||||
How will you exercise your dog? |
On leash | ||||||
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? |
NA – I live in an apartment building | ||||||
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: |
NA | ||||||
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? |
Georgie Brown | ||||||
Willing to train children? |
NA for me but yes for any children I interact with. I think it's very important that children learn to respect and treat animals well and to read their signs. | ||||||
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? |
NA – I don't have any other pets | ||||||
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} |