Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/06/2021 | 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: |
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Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
Me and my husband | ||||||
Why do you want a Pembroke? |
Corgis have always been a huge part of my (Rachel's) life. I grew up with two Corgis (one Pembroke and one Cardigan) from junior high through graduate school. They may have lived at my parents' house, but I was actively involved in their care and development, including taking one of them through obedience classes and basic agility training. My parents and I did extensive research before finding our Corgis by reading books and reputable websites, speaking with family friends who are dog breeders, and attending local dog shows. | ||||||
Activities planned with Pembroke: |
We would do much of the same activities Rachel did with her dogs: play in the backyard, go for walks, run in the park, provide toys that exercise the mind, relax on the couch, and love on them often (unless they dislike being cuddled, in which case we would absolutely give them the space they need; one of Rachel's dogs was not a cuddler, so she has some experience). | ||||||
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: |
I would clearly and firmly give a short, "Hey!" to get their attention and redirect them to something else. I might physically guide them away from the thing I want them to get away from. | ||||||
Discipline: |
To be honest, it has been some time since I have had to discipline a dog, and I do not remember exactly what methods we used on our previous dogs besides sending them to their crates for a "time out". We never hit them or used any other forms of corporal punishment. I am keen to learn new and better ways of disciplining. | ||||||
Where would Pembroke spend the majority of the time: |
They would be indoors most of the time, mostly on the first and/or second floor of our house. They would mostly be free to roam the house and not be confined to their crate unless we both have to leave the house. They would also spend plenty of supervised time in the backyard. | ||||||
Discipline: |
To be honest, it has been some time since I have had to discipline a dog, and I do not remember exactly what methods we used on our previous dogs besides sending them to their crates for a "time out". We never hit them or used any other forms of corporal punishment. I am keen to learn new and better ways of disciplining. Where would Pembroke spend the majority of the time: They would be indoors most of the time, mostly on the first and/or second floor of our house. They would mostly be free to roam the house and not be confined to their crate unless we both have to leave the house. They would also spend plenty of supervised time in the backyard. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. Currently, I am teaching online four days a week, and my husband is an online student taking classes from home. | ||||||
Where would dog eat? |
They would eat in the kitchen or dining room. | ||||||
Where would dog sleep: |
Depending on the dog's comfort level, we would be fine with them sleeping in our bedroom either in a dog bed or on our bed. If the dog prefers to sleep in their crate, we would be okay with that as well. | ||||||
Play & exercise: |
They will be walked several times a day and allowed in the backyard at least once a day. We would also do lots of playing indoors. As previously mentioned, we also intend to provide toys not only for fun but for exercising the mind. | ||||||
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? |
Currently, it is a white picket fence that is slightly above waist height. However, it is nearing time to replace it, and we fully intend to do so with a taller fence made of sturdier material. | ||||||
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? |
Yes | ||||||
Description of yard: |
The front yard is not fenced and includes a small garden in the middle of the lawn with a large tree, flowers, and garden decorations (small wooden bridge, sun dial, and solar-powered lights). There are flowers, short bushes, and rocks lining the driveway and a stone flowerbed on the front of the house. The backyard is fenced (see description on p. 6) and has medium-height bushes along the back of the house. There is a shed and rocky/gravel area in one corner and an air conditioner unit (fenced off) in the other corner. There are flowers and small or medium garden decorations in the other two corners of the yard. The rest is just regular grass. | ||||||
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? |
Rachel Israel | ||||||
Willing to train children? |
Yes, if we have children in the future, we will take the time to teach them everything they must know about caring for animals. | ||||||
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? |
Yes, we are. In fact, I (Rachel) have experience with this. When my parents and I decided to adopt a second Corgi, the two dogs didn't always get along and got into several scuffles and fights. While they were usually intense situations, we always managed to separate them and calm them down. | ||||||
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} |