Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 08/26/2020 | 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 | 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? |
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? |
Our family, which is me, my husband, and our two kids who are 8 (boy) and 5 (girl) | ||||||
Why do you want a Pembroke? |
Our family has been interested in Pembroke Welshe Corgis for some time. We love their fluffs, and their expressive personalities. I have loved corgis for the longest, and have spread the love to my husband and children. We are in a place now that the kids are old enough to seek out a dog that we can love and care for. My daughter, who is on the shorter end of the spectrum, also really likes corgis because they are short and not overwhelming like some of the big dogs. The personalities of my children who are kind, loving but also adventurous seems like it would fit the personality of the corgi well. | ||||||
Activities planned with Pembroke: |
We love taking walks, and playing in our fenced yard. We would also like throwing a ball and stick, watching movies, watching the famous corgi zoomies, giving our corgi snuggles and pets, and being general buddies. | ||||||
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: |
Tell the pup no and use positive reinforcement to guide them to the correct behavior | ||||||
Discipline: |
Classical conditioning with positive attention for good behavior and redirection is how I have trained my human babies, and plan to use similar techniques with fur babies for our family. | ||||||
Where would Pembroke spend the majority of the time: |
Inside the house, in a dog bed in the living room and a crate in the dining room. The kids would likely want the corgi to snooze with them in their rooms, and we would take the corgi outside every day to exercise and play | ||||||
Discipline: |
Classical conditioning with positive attention for good behavior and redirection is how I have trained my human babies, and plan to use similar techniques with fur babies for our family. Where would Pembroke spend the majority of the time: Inside the house, in a dog bed in the living room and a crate in the dining room. The kids would likely want the corgi to snooze with them in their rooms, and we would take the corgi outside every day to exercise and play |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
We are all currently home all day for the foreseeable future | ||||||
Where would dog eat? |
Their dish would be in the dining room | ||||||
Where would dog sleep: |
In their crate in the dining room | ||||||
Play & exercise: |
Our family is active and go for walks often. There are also lots of opportunities to play outside in the fenced yard with the family during the day since school will be remote this year. | ||||||
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? |
The fence runs the perimeter of the backyard and is totally enclosed. | ||||||
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? |
No, you may not 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? |
Not applicable | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
The yard is an L-shape with the fence around the perimeter. There is a wooded area in the corner that the kids have turned into their club house. There are 2 fence gates that are closed when not being used | ||||||
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? |
Sara (Me) | ||||||
Willing to train children? |
We have been talking about how to treat a dog for a long time, so the kids have knowledge going in about how to treat dogs, but we will do all we can to help them have a good relationship with the dog | ||||||
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? |
Not applicable | ||||||
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} |