Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 09/06/2020 | 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 |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
Dog 1 |
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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? |
This dog is for our family. We've been missing having a dog companion in our home. We are looking for a furry walking buddy, movie snuggler, and playful friend for our children. | ||||||
Why do you want a Pembroke? |
We started to see a lot of corgis in the country (they were very popular there) we had been living in and started to fall in love with them. Their fun and contagious happiness and playful natures. We had friends involved in rescues there and got to know the breed a little bit through their fostering. We repatriated to the US last December and have been looking for a dog since. We went to the Chicago Chinese New Year parade and saw several corgis dressed as ancient lions and my youngest son in particular got very excited and he fell in love. We've been reading books about corgis and watching all kind of corgi movies ever since. We've got corgi lego sets and stuffed animals. It's become a sort of joke…that our family is *low-key* obsessed with corgis but ironically doesn't have one. | ||||||
Activities planned with Pembroke: |
We are looking for a walking buddy, so daily walks and trips to local dog parks. We also like to road trip and camp. My two sons are busy and active and they love to play with dogs. A corgi in our family would get lots of love and attention. | ||||||
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: |
With our previous dog, we tried to stay calm and firm about the command/correct action. Repeating the command, redirecting the dog and then when they get it right giving lots of praise, love and if needed training treats. | ||||||
Discipline: |
We think the best thing that can be done is to be consistent. We love lots of positive reinforcement. We've never approved of physical discipline for animals, same as our children, and think that respect goes both ways as the dog trusts you, you can trust them; it's a relationship and should be based in love. | ||||||
Where would Pembroke spend the majority of the time: |
At home with us. Right now Jonathan is working from home. I have a very flexible work schedule and am actually mostly home as well (my doula and teaching work is very part time). The kids are also home doing e-schooling as of now. So our corgi would be home with us; we haven't ever need to use a daycare service for our dog. | ||||||
Discipline: |
We think the best thing that can be done is to be consistent. We love lots of positive reinforcement. We've never approved of physical discipline for animals, same as our children, and think that respect goes both ways as the dog trusts you, you can trust them; it's a relationship and should be based in love. Where would Pembroke spend the majority of the time: At home with us. Right now Jonathan is working from home. I have a very flexible work schedule and am actually mostly home as well (my doula and teaching work is very part time). The kids are also home doing e-schooling as of now. So our corgi would be home with us; we haven't ever need to use a daycare service for our dog. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, at various times all four of us are home. In pre-covid life, Katrina is home during the day (minus errands, etc). | ||||||
Where would dog eat? |
We put bowls in our kitchen. | ||||||
Where would dog sleep: |
We've had a few doggie beds before, like one on each floor of the house. Our previous dog loved to lounge and sleep there, also sometimes on the downstairs couch. She didn't seem to prefer sleeping in our rooms, but we always left it free to wander and choose where she preferred at night. We are open to finding out where our new corgi would like to sleep and will provide lots of comfy options. | ||||||
Play & exercise: |
We plan on taking at least one trip per week to the dog park. We also have friends with dogs that like to go there. We plan on daily walks 1-2. Also our sons are very excited to have a dog to playfully tug-o-war with and run with and so on. They like it very much with our friends' dogs. | ||||||
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? |
It is a chain-link fence that fully covers our backyard. There are two gates one to the front yard and one that leads to the detached garage. It is just under 4 feet high. | ||||||
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: |
We have no permanent fixtures in our yard. In the warmer months we put a trampoline for the kids. Other than that, it's just a spot of open grass and some trees. | ||||||
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? |
Katrina | ||||||
Willing to train children? |
Yes, of course! My boys are generally wonderful with animals, but continued reminders and teaching by modeling/example is always good for these growing boys too. | ||||||
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? |
We have no plans for other pets, but yes we would work to resolve any problems. | ||||||
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} |