Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 08/28/2020 | 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: |
5 years – 10 years | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Outgoing, Playful |
Other preferences: |
We currently have a 5 year old lab mix so the Corgi would need to do well with other dogs. We have a decent sized fenced in yard so there is room to run and play. | ||||||
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? |
Us | ||||||
Why do you want a Pembroke? |
We want to adopt a Pembroke Welsh Corgi because we absolutely love the breed. They are a smaller dog which makes it easier to travel with them. They're super smart and like to stay busy. I have done research and know that they need to stay busy and they love to be praised by their owner. I also know they are herding dogs. I have 2 friends with Corgis and they are both amazing dogs. | ||||||
Activities planned with Pembroke: |
We would go for lots of walks, play fetch in the back yard, car rides, trips to friends houses to play with other dogs, and lots of snuggles and pets. | ||||||
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: |
Calmly but sternly let he/she know that whatever action they did was not okay and redirect them to something that is ok in place of the wrongdoing. | ||||||
Discipline: |
Sternly tell the dog no Sometimes when being naughty we tell our dog to go lay in his bed or go lay down |
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Where would Pembroke spend the majority of the time: |
In our home/yard | ||||||
Discipline: |
Sternly tell the dog no Sometimes when being naughty we tell our dog to go lay in his bed or go lay down Where would Pembroke spend the majority of the time: In our home/yard |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Not at the moment but we are able to go home during lunch breaks | ||||||
Where would dog eat? |
In our kitchen | ||||||
Where would dog sleep: |
In our bedroom | ||||||
Play & exercise: |
We live by a park that has a fenced in dog area so we can take he/she for a walk to the park and let them play. We also have a good sized fenced in yard for he/she to play in as well. We are friends with a couple that has 3 dogs and they run around and play with our current dog in the backyard when they are over. He/she will get to play and exercise every day! | ||||||
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 is around the entire perimeter of our yard. It is about 4ft tall. It is a steel chain link fence. | ||||||
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: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
The only thing we really have in our yard is a shed, a picnic table, a fire pit, and a little plastic pool for our dog. | ||||||
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? |
Shelby Price | ||||||
Willing to train children? |
We do not currently have any children. However, when we do we are more than willing to teach he/she how to humanely care for 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? |
Yes. | ||||||
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} |