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: |
1 year – 3 years | Gender preferred: |
Female | Color preferred: |
Any color | Activity level: |
Outgoing, Quiet, Playful, Energetic |
Other preferences: |
I have a cat in the house, no kids but a ton of kids in the neighborhood so a Corgi with kid experience would be nice | ||||||
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? |
Me – Julie Meyer | ||||||
Why do you want a Pembroke? |
My first dog just passed – she was a mix and had some corgi in her. I love their size (perfect size in my opinion not too tiny and not too large). I like that they are smart dogs and appear to have tons of personality. My mix sure did. | ||||||
Activities planned with Pembroke: |
Everything – daily walks, sometimes short sometimes long. I'll bring her with me on errands and to dog-friendly patios. I always schedule patio outings with friends even before Covid so that I could bring my dog. Socially distant friend visits. When my dog was too ill to walk more than 2 blocked I brought her along with me on longer walks in a cart. | ||||||
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: |
With Shefu I would sternly say No and try and stand alpha with legs apart to show i was in charge | ||||||
Discipline: |
Just stern words and then redirect (pee in the house? use stern voce and bring her to her pee pad or outside whatever is closer) and also interrupt her if she looks like she is going to do something (maybe jump on me) and try and redirect her behavior towards a toy | ||||||
Where would Pembroke spend the majority of the time: |
At my house with me I am full time work at home | ||||||
Discipline: |
Just stern words and then redirect (pee in the house? use stern voce and bring her to her pee pad or outside whatever is closer) and also interrupt her if she looks like she is going to do something (maybe jump on me) and try and redirect her behavior towards a toy Where would Pembroke spend the majority of the time: At my house with me I am full time work at home |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes I work from home | ||||||
Where would dog eat? |
in the kitchen | ||||||
Where would dog sleep: |
In one of multiple dog beds around the house – unfortunately not with me I have a high bed and would worry about her jumping down in the night and hurting herself | ||||||
Play & exercise: |
I have a fenced in back yard and will walk her daily there are tons of dogs in my neighborhood so many opportunities for socializing. I'd also like to try dog parks my last dog didn't like them but if my new dog doesn't like them that is OK | ||||||
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? |
Black chain link with a gate | ||||||
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: |
A small back yard, fenced in with a large oak and some smaller trees. No pool just a 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? |
Julie (Me) | ||||||
Willing to train children? |
I don't have kids | ||||||
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 | ||||||
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} |