Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 02/20/2021 | 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: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
As I've said, I've had 2 rescues, and woul LOVE to rescue another | ||||||
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? |
For myself son and wife (misty).. have rescued 2 in my life to date, Kiera lived to 11, but passed last year, and Ms. Barker… It's been the best dogs I've ever owned.. would love to give another a home and have a little buddy to keep me company throughout the day. | ||||||
Why do you want a Pembroke? |
Kira was my couch potato.. went everywhere I did.. the loyalty of Corgi breed is amazing. Ms. Barker was like a super many to my son lol. No joke I swear she thought she was his mom, but was very loving to him. | ||||||
Activities planned with Pembroke: |
I love walks, so that'd be a given.. but vacationing is a plus too.. no one quite gets dogs love to see new things as well if they feel secure with their owners. | ||||||
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? |
No | ||||||
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: |
Go through the routines again.. they're are smart and eventually run themselves on auto pilot.. it's all in the training not the scolding | ||||||
Discipline: |
I snap my fingers, and keep eye contact for a few seconds.. the snap breaks their concentration, and the dog can feel the energy of a Stern good stare down.. most anything more is intimidating and not discipline.. if you want a life long friend never intimidate your dog.. direct them.. | ||||||
Where would Pembroke spend the majority of the time: |
By my side, inside while I'm writing drawing and watching TV, and walks I take daily | ||||||
Discipline: |
I snap my fingers, and keep eye contact for a few seconds.. the snap breaks their concentration, and the dog can feel the energy of a Stern good stare down.. most anything more is intimidating and not discipline.. if you want a life long friend never intimidate your dog.. direct them.. Where would Pembroke spend the majority of the time: By my side, inside while I'm writing drawing and watching TV, and walks I take daily |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes myself I'm retired | ||||||
Where would dog eat? |
Food dish beside dinner table when we eat, or his/her "space" will be leftover dog food and water.. by space I mean inside place for their bed and favorite toys.. | ||||||
Where would dog sleep: |
Foot of my bed | ||||||
Play & exercise: |
Daily 2 mile walks, and bring to paws daily for socializing with other dogs at their dog park facilities | ||||||
How will you exercise your dog? |
On leash | ||||||
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? |
4ft high 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: |
500 sq ft fenced in back yard, driveway, and flower garden in front | ||||||
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? |
Myself Preston | ||||||
Willing to train children? |
He is fully trained with dogs of all sizes | ||||||
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? |
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Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
N/A | ||||||
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} |