Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 02/23/2021 | Referred by: | Website, Veterinarian | ||
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: |
3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Red & White, Red Headed Tri, Sable & White, Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic, Other (Please describe in the box below.) |
Other preferences: |
I love my dog, and try to give it the care it needs and wants. I never would tie it up out side and leave it alone as I want an indoor dog. | ||||||
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? |
I submitted an application several weeks/month ago,but I have not heard recently from anyone. I remember a "Jim" but I don't have any contact information. When I try to make a connection, I get an error message. My phone number is 269-964-0729. I live in Battle Creek, MI and would like an older dog, male or female. 140 Waupakisco Bch. 49015 My email addresses do MATCH. |
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Why do you want a Pembroke? |
I have researched the breed in the ASPCA Complete Guide to Dogs by Sheldon L. Gerstenfeld, V.M.D According to the author, the dogs are bright and easy to train. They that do have some health issues that need to be checked, but the breed seems to have no negative traits and are wonderful, medium sized dogs. | ||||||
Activities planned with Pembroke: |
I would love to take my dog on walks, pet him or her and brush and groom them. A dog that wants to go on short car rides with me and sleep on an L.L. Bean bed in various parts of my house: the kitchen, the living room, my bedroom, the porch and my Gazebo would be great. Yes, I do have several beds all over the house. | ||||||
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 what the mistake was, I would clean it up and take the dog outside. I would also try to take some stool or urine outside for the dog to smell. If it was a chewing error, I would take the offending object away and substitute a toy to chew on. |
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Discipline: |
I never hit an animal; I use preventative measures and plenty of love and attention. I do raise my voice somewhat for a "no" in a stern voice . I never have had the problem of barking, but I would look it up in my dog book. |
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Where would Pembroke spend the majority of the time: |
With me in the house or outdoors on a walk. | ||||||
Discipline: |
I never hit an animal; I use preventative measures and plenty of love and attention. I do raise my voice somewhat for a "no" in a stern voice . I never have had the problem of barking, but I would look it up in my dog book. Where would Pembroke spend the majority of the time: With me in the house or outdoors on a walk. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
As a retired person, I'm home a lot. When my husband was alive, and we both were newly retired, we traveled a great deal, but now I'm very content to stay home. | ||||||
Where would dog eat? |
In the kitchen out of his or her dog food bowls, with fresh water at all times. | ||||||
Where would dog sleep: |
Where ever he or she wanted to on her bed in the room that I'm in. Are Corgis lap dogs? I don't know, because I have always had large dogs, but now I would like to have a medium sized dog. |
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Play & exercise: |
Every day the dog could go out and walk and play. Some dogs don't care to go out in the rain etc. | ||||||
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? |
I have an electric fence and will finish a dog fence area as soon as the snow is gone. I do have a 25' cable by my front door that I can put the dog on and I watch every minute he/she is out from the storm door window or kitchen window. | ||||||
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: |
I have an acre lot with out a pool, but I do live on a lake and the electric fence is about twenty feet away from it. This is why I am always watching my dog when she/he goes out. I had a Weimaraner who could not swim even when my son-in-law tried to teach her. |
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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? |
Mary Kreiter | ||||||
Willing to train children? |
My children (except for one who has cats) all have dogs and cats of their own.
I don't allow small children that I meet on my walks to pet my dog by saying I don't know how the dog would react which is true. |
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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? |
The cat is really my grandsons, and he could take it back now as he currently lives in a house. |
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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} |