Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 11/05/2020 | 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
I would like a dog that's going to get along with everyone. We tend to have lots of different people over to the house. We live on a farm that has cattle and goats, we have 1 house cat and 2 pet rabbits. | ||||||
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? |
It would really be my dog (mom), but obviously needs to be good for the whole family. My girls are 9 and 11 and I tend to have lots of people (friends, kids of friends, family) around the house. | ||||||
Why do you want a Pembroke? |
I have researched the breed, as well as, met several. I used to read electric and gas meters, therefore had the opportunity to meet lots of different dog breeds. I have always loved the look and personality of the Corgi's. | ||||||
Activities planned with Pembroke: |
Walks, family time, camping, I would love to take it paddle boarding if able to train it to ride with me :). | ||||||
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 |
||||||
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: |
I will be taking the Pembroke to training and handle it however recommended by the trainer (will be looking for a trainer that uses positive reinforcement). | ||||||
Discipline: |
When I adopted the love of my life (a Brittany Spaniel mix), 13 years ago, the trainers that I used, used training collars (a.k.a. choke collars), I will NOT go that route again. With that being said, I will be kind of starting over from scratch with my training knowledge. | ||||||
Where would Pembroke spend the majority of the time: |
Preferably with me. | ||||||
Discipline: |
When I adopted the love of my life (a Brittany Spaniel mix), 13 years ago, the trainers that I used, used training collars (a.k.a. choke collars), I will NOT go that route again. With that being said, I will be kind of starting over from scratch with my training knowledge. Where would Pembroke spend the majority of the time: Preferably with me. |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
For the most part. Most days, there will only be a few hours during the day that no one would be home. | ||||||
Where would dog eat? |
Either in our entryway (where the crate would be), or in our kitchen, next to our refrigerator. It really depends on how much displacing her, would affect our current cats well being. | ||||||
Where would dog sleep: |
We usually place a dog bed next to my side of the bed, and they could either sleep there or on the bed with us. | ||||||
Play & exercise: |
On leash, fenced in area with our goats, house play (yes, controlled fetch is allowed indoors at our house! 🙂 ). My dream would be to eventually teach him/her to stay in yard, but it took me approximately 8 years in order to trust my last true love with that responsibility. | ||||||
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? |
|||||||
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? |
|||||||
Lease allow dogs: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We have a dog tie out off the back patio for quick potty outings. We do have an above ground swimming pool, the tie out reaches the deck, but not the pool. We have a fenced in area, where we keep our goats. Our house only sits on a little under 1 acre, but because we are in the farmhouse connected to my in-laws farm, we have access to close to 100 acres. | ||||||
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? |
Heather Turnwald | ||||||
Willing to train children? |
My children currently own and take care of 1 goat and 1 rabbit each and also take care of my father in laws barn cats and our indoor cat ( I do keep an eye on things, because they are still kids and sometimes forget or miss things). | ||||||
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. Our cat Patches has never exactly been thrilled with a dog friend, but she gets along well enough and is front declawed. | ||||||
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} |