Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 11/29/2020 | 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, 3 years – 5 years, 5 years – 10 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? |
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? |
Its for my wife and I. | ||||||
Why do you want a Pembroke? |
My wife and I love the playful energy often associated with corgis. We understand every dog is different, but we know they tend to be social energetic companions. They're just so entertaining. We love how they have a reputation for intelligence and affection. | ||||||
Activities planned with Pembroke: |
We would walk them and play with them the same as our other dogs. We throw frisbees and balls back and forth along with training exercises for stimulation. We built a fence around our yard specifically for our dogs so they could exercise and play. | ||||||
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: |
Depending on the behavior, usually telling them "No". (Not yelling, just direct). Getting the dog to focus on me and putting them in a "sit" or listening setting. Redirection, or not rewarding attention for bad behavior. Always staying calm. | ||||||
Discipline: |
Rewarding positive behavior after interrupting or redirection from the bad behavior. Showing a calm energy. Having the dog focus on me, rather than what they're doing thats bad. | ||||||
Where would Pembroke spend the majority of the time: |
In our home with our other dogs. We are experienced in crate training. We let our dogs play in the yard or inside as much as we can. | ||||||
Discipline: |
Rewarding positive behavior after interrupting or redirection from the bad behavior. Showing a calm energy. Having the dog focus on me, rather than what they're doing thats bad. Where would Pembroke spend the majority of the time: In our home with our other dogs. We are experienced in crate training. We let our dogs play in the yard or inside as much as we can. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. Our schedules change sometimes but we always make sure one of us is home, so that the dogs are not alone for more than a few hours. | ||||||
Where would dog eat? |
In our kitchen where we keep the dog food and bowls. | ||||||
Where would dog sleep: |
Likely in their crate. Our dogs have responded well to crate training and often use them as their comfort space. We never use a crate as a punishment or for negativity. | ||||||
Play & exercise: |
We have a large fenced in yard that is great for having the dogs run and play. We live in a dog friendly neighborhood ideal for walking as well. | ||||||
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 4 FT aluminum, wrought iron style fence. The gaps between the bars are just a few inches, so there's no risk of our dogs getting stuck or being able to go through the 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: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
Our yard is pretty open once inside our fence. There arent any trees or obstacles inside the yard. We have steps going up to the back sliding doorwall where the dogs go in and out of the 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? |
Donald Pranger | ||||||
Willing to train children? |
Of course. We understand kids and young children dont understand how careful to be around animals. We will take all necessary measures to make sure our animals are treated well and always in an environment where they feel safe. | ||||||
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. We will make sure all of our dogs get along and are comfortable around each other. We understand this can take time 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} |