Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 12/26/2020 | 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: |
5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Quiet |
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? |
The corgi would be for my mom, Pat Buttney, who is looking for a dog for companionship. She has always had a dog and misses the companionship, especially during this pandemic. My mom lives in coach house in nearby retirement village where she can take the corgi for walks and lavish her new companion with all her love. | ||||||
Why do you want a Pembroke? |
My mom has never owned a Pembroke Welsh Corgi but I have friends that have them and I have come to love the breed. The corgis I have met are sweet, loving and just want to be with their humans. I have done a little further research on the breed and after talking everything over with my mom, we both feel the Pembroke would be a good match for her. Pembroke Welsh Corgi's are just the right size and have the loving temperament we're looking for. | ||||||
Activities planned with Pembroke: |
Basically we're looking for a a companion for my mom. A corgi who is happy to cuddle with here and get plenty of attention. Plus, an Corgi that will go on slower walks with my mom. | ||||||
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: |
Sternly say no, not associating his/her name with the "no" and move on. Then when I show the dog the behavior I'm looking for and he/she completes the task, I would generously reward the dog with his/her favorite treats and plenty of praise. | ||||||
Discipline: |
Basically just using the word "no" and not rewarding her/him for that behavior. | ||||||
Where would Pembroke spend the majority of the time: |
In the house with my mom or anywhere else she might be. | ||||||
Discipline: |
Basically just using the word "no" and not rewarding her/him for that behavior. Where would Pembroke spend the majority of the time: In the house with my mom or anywhere else she might be. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, my mom is home all the time. If she is gone for periods of time, it is for short periods such as for a trip to the doctor or grocery store. When she visits my house or one of my siblings house, we all live in the area, the Pembroke would come would come with her to visit. | ||||||
Where would dog eat? |
the adopted corgi would eat in a designated area set up in the kitchen. | ||||||
Where would dog sleep: |
The corgi would sleep would sleep in my moms bedroom. He/she would have the choice to sleep in the bed with my mom or in its own bed in the same bedroom. The corgi can decide what he/she would like to do. | ||||||
Play & exercise: |
The corgi will have plenty of playtime with toys that he/she can play with either by themselves or with my mom. Walks will also be provided for daily exercise. | ||||||
How will you exercise your dog? |
On leash | ||||||
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: |
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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
My moms coach house does a patio that is fenced on one side, but is open to a common area in the back. There is no pool in the area and the corgi would always be taken outside on a leash. When my mom visits any of her children in the area, we all have fenced yards where the corgi would be free to run and play. | ||||||
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? |
Pat Buttney | ||||||
Willing to train children? |
There are no children in the household and all grandchildren are adults. If great grand-children were visiting, they have been around other family members dogs and understand what required to care for dogs and other family pets. | ||||||
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 never given up on a pet who may not get along with another individual pet we may have. It may take patience, time and training but these situations can be resolved. | ||||||
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} |