Untitled_3720

Applicant IL
State: {Applicant State:2} Date of Application: 03/27/2021 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:
 0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years
Gender preferred:
 Female, Either a Male or a Female
Color preferred:
 Red Headed Tri, Black Headed Tri, Any color
Activity level:
 Couch Potato, Outgoing, Playful

Other preferences:
 I will be living with my parents while I am home from school and they have a border collie/boxer mix. She is very friendly and has lived with another dog before.

Previous dog owner?
 No
 
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?

 Myself (Rebecca)

Why do you want a Pembroke?
 I love this breed because of how comforting and affectionate they are towards their owners. I am looking to make the corgi an ESA if I have the honor of being accepted. I have read many times over that corgis make great emotional support animals and that they are very loyal to their owners, along with being very intelligent and get along with other animals well, though I also recognize that this can vary from dog to dog and is based on their training.

Activities planned with Pembroke:
 I would want to bring it with me whenever possible; to go shopping(when appropriate), going on walks/runs, visiting my friends, road trips, playing at the dog park, learning tricks and discipline, etc.

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?

 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 try to correct the mistake by showing them what is correct and rewarding them so that they know what they are doing is correct and that not receiving a reward(treat), means that what they did was not correct.

Discipline:
 Be consistent in my training and word choice, behavior correction through training and a reward system, give timeouts, and be as positive as possible when they do things correctly and remain calm and patient when they do something wrong.

Where would Pembroke spend the majority of the time:
 In my dorm room. I have one more year of being required in a dorm room. After that, I plan to get a house with a back yard.

Discipline:
 Be consistent in my training and word choice, behavior correction through training and a reward system, give timeouts, and be as positive as possible when they do things correctly and remain calm and patient when they do something wrong.
Where would Pembroke spend the majority of the time: In my dorm room. I have one more year of being required in a dorm room. After that, I plan to get a house with a back yard.

House dog or outside dog?

 House dog

People at home during the day?
 Living with my parents, yes. Living in my dorm, potentially. I would be structuring my schedule to ensure that I can return home often for long enough periods of time to take the corgi on walks and make sure it is getting plenty of exercise and attention throughout the day.

Where would dog eat?
 In my bedroom or in the shared space of my dorm room.

Where would dog sleep:
 In its crate, a dog bed, or in bed with me, depending on the preferred comfort and temperament of the dog. I've lived with dogs who prefer the floor, dogs that don't care for dog beds, and dogs that prefer to be in the comfort of being in a crate.

Play & exercise:
 I plan to take my corgi on 3 walks a day, possibly runs as I would like to go on morning jogs but I don't feel comfortable doing so alone, but having a dog with me would certainly add comfort. I would also like to take it to the dog park regularly to play fetch and to interact with other dogs, and we would have play time throughout the day, and especially at night before bed.

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?

Living arrangements:
 In my parents house during the summer, in a dorm room for most of the year(until new arrangements can be made based on the scholarships I receive through my college)

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?
 Not applicable

Breed/size restrictions?
 No

Description of yard:

 My parents' house has an above-ground pool and the yard is very spacious with lots of grass and a large tree for shade. There is a pond in the backyard with a fence around it. There are plants that also have fences around them as well. The entire yard is fenced in.

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?
 Rebecca Piepszak

Willing to train children?
 I do not have nor do I live with any children, but if I do end up having any children during the lifespan of my corgi, I would raise them to love and care animals of all shapes and sizes and I would teach them that though they don't look or speak like humans, they deserve respect, love, and fair treatment, just like humans do.

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?
 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}