Untitled_3586

Applicant IL
State: {Applicant State:2} Date of Application: 01/15/2021 Referred by: Website
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

Ages interested in:
 1 year – 3 years
Gender preferred:
 Female
Color preferred:
 Any color
Activity level:
 Couch Potato, Outgoing, Quiet, Playful

Other preferences:

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}

Who is this dog for?

 Julie and Steve Nowak

Why do you want a Pembroke?
 We had a Pembroke Welsh Corgi who passed away a few years ago. We had her from birth. She was a fluffy corgi. She had a wonderful, gentle personality and was loved by our family of 5. She was a wonderful pet for our 3 children. She wasn’t super energenic, although the high energy level (and cuteness) was why our son picked the breed. She loved to go for walks, we also have 5 acres in Wisconsin and she loved to be out in the yard with us there.

Activities planned with Pembroke:
 We plan on going for walks, playing catch and practicing training skills.

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: 		If I noticed while it was happening, I would remove the dog from the situation, make a note of what happened and investigate ways to train the dog not to repeat the mistake.

Discipline:
 Removal from the situation, retraining

Where would Pembroke spend the majority of the time:
 We split our time between Chicago and Wisconsin. We are both currently home all day, I will still be at home after Steve goes back onsite. We have not ever confined our dogs to an area of our homes.

Discipline:
 Removal from the situation, retraining
Where would Pembroke spend the majority of the time: We split our time between Chicago and Wisconsin. We are both currently home all day, I will still be at home after Steve goes back onsite. We have not ever confined our dogs to an area of our homes.

House dog or outside dog?

 House dog

People at home during the day?
 I will be home during the day.

Where would dog eat?
 We understand that there are many options available and would be looking for advice on what to feed her.

Where would dog sleep:
 With our old corgi, she slept on a dog bed in our room.

Play & exercise:
 I will be able to provide her with walks and there are parks to play in during the day. In Wisconsin, there is lots of room to play and walk 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?
 In Chicago we have an enclosed front enclosure and a back enclosure, she would be able to be in off leash. We do not have a fence in Wisconsin. We have long cable with a stake we would use if not walking her on a leash.

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?
 No, the condo covenants do not prevent me from having a dog.

Breed/size restrictions?
 No

Description of yard:

 We have an apartment in Chicago and a house in Wisconsin. The house in Wisconsin has no ponds or pools.

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?
 Julie

Willing to train children?
 Yes

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?

Are you willing to work on it if your new dog doesn’t get along with your current pets right away?
 Yes

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}