Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 11/23/2020 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Other (Please describe in the box below.) |
Other preferences: |
I had Corgis growing up and enjoy/know the breed | ||||||
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 would be a dog for our family. We rescue/foster border collies with Clancy’s Dream Rescue. We would love to add a corgi in need of a home to our pack | ||||||
Why do you want a Pembroke? |
I had several growing up. I’ve always considered getting one as an adult. As an adult I’ve had Australian shepherds and border collies and I enjoy the hearder mentality in a dog | ||||||
Activities planned with Pembroke: |
We are an active outdoor family that takes our dogs everywhere we can. Camping, hiking, family vacations, etc. we are all avid dog lovers | ||||||
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: |
Depends. We have learned through fostering 14+ dogs over the last two years dogs have various adjustment times that can last months. Aggression is a big no. Other temperament issues are most dealt with positive reinforcement and consistency | ||||||
Discipline: |
I’m big on rewarding positive behaviors but more than anything consistency. | ||||||
Where would Pembroke spend the majority of the time: |
Inside the house. We have open crates for our current dogs for comfort but they have free reign of the indoors and usually sleep in our bed. We have a large fenced in back yard for play | ||||||
Discipline: |
I’m big on rewarding positive behaviors but more than anything consistency. Where would Pembroke spend the majority of the time: Inside the house. We have open crates for our current dogs for comfort but they have free reign of the indoors and usually sleep in our bed. We have a large fenced in back yard for play |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Rarely are our dogs without a human for more than 4 hours | ||||||
Where would dog eat? |
Inside- we feed 2x a day with dispersed bowls to prevent food aggression or anxiety | ||||||
Where would dog sleep: |
The kid/adult bedroom (or bed!) of its choosing | ||||||
Play & exercise: |
We have 3 young Aussies or Border collies so no lack of energy here. We also have 4 kids age 11-16 and our family is avid hikers/outdoors so plenty of play, walks, and outdoor life | ||||||
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? |
We have a 6 ft tall wooden 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: |
We live at a cul-de-sac .25 acre lot with a fence | ||||||
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? |
Liz Crawley | ||||||
Willing to train children? |
YES!!! As someone who has fostered for over 2 years this is something that is incredibly important to our household | ||||||
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 dogs have been ‘hosting’ foster border collie rescues for 2 years and it’s taught them & us about dog resolution, tolerance of issue, and patience. | ||||||
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} |