Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 10/08/2020 | 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: |
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? |
For both of us. | ||||||
Why do you want a Pembroke? |
We would love to adopt a Pembroke Welsh Corgi for their loving nature and big personalities! There are a few corgis that live in our building that our dog could socialize frequently with, and our experience with these corgis makes us appreciate their breed even more. We love that they are great with people and they are also adorable. | ||||||
Activities planned with Pembroke: |
We would go on frequent daily walks as well as have our Pembroke socialize with other dogs in our building's dog run and at the neighborhood dog park. We have a lot of dog friendly bars/establishments in our neighborhood which would make taking our Pembroke out with us easy. This would also mean that we would not have to leave them home alone often at all. | ||||||
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: |
We would handle it as what it is, just a mistake. Depending on the mistake, it may lead to a stern "No," but we believe that mistakes happen and that the best way to train a dog to avoid mistakes is encouragement and positive reinforcement. | ||||||
Discipline: |
We believe that discipline should not go further than a stern voice. We would aim to train our dog with positive reinforcement (e.g., treat rewards). | ||||||
Where would Pembroke spend the majority of the time: |
They would spend most of their time in our apartment when they aren't on the dog run with us, hanging out on our fenced rooftop area, or on walks with us. | ||||||
Discipline: |
We believe that discipline should not go further than a stern voice. We would aim to train our dog with positive reinforcement (e.g., treat rewards). Where would Pembroke spend the majority of the time: They would spend most of their time in our apartment when they aren't on the dog run with us, hanging out on our fenced rooftop area, or on walks with us. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, we are both currently home all day. After covid, Luke will return to the office daily while I will be at schools for at most 3 hours a day. | ||||||
Where would dog eat? |
They would eat in our kitchen area near the table. | ||||||
Where would dog sleep: |
Ideally they would sleep in the family room area on a dog bed (or if absolutely necessary, a crate). However, if they had attachment issues we would allow them sleep in the bedroom. | ||||||
Play & exercise: |
Our work schedules (specifically mine) are flexible and allow us to take out our corgi often throughout the day. This includes walks (and jogging if they can keep up!) as well as play time with other dogs on the dog run and in the fenced rooftop area. | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
Fenced yard? |
No, I don’t have a fenced in yard. | ||||||
Willing to pick up dog waste? |
Yes, I will clean up after my dog. | ||||||
Willing to use a crate? |
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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? |
Not applicable | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
Do not live in a house. | ||||||
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? |
Lauren Patton | ||||||
Willing to train children? |
We do not have children, but if we did we would be willing. | ||||||
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? |
Yes, we would work to solve the problem ourselves and contact professional help if necessary. However, this dog would be our first and primary concern and any other pets we add (possibly another dog down the road as a companion) would be checked to make sure they get along with this first dog. | ||||||
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} |