Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 04/22/2021 | 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, Quiet, Playful, Other (Please describe in the box below.) |
Other preferences: |
If there is a corgi that does not bark when alone for an hour or so (that is the most they would be alone) that would be good so as to not bother my neighbors. | ||||||
Dog Ownership History | |||||||
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} | ||||||
Questions Regarding Motivation for Adopting and Intentions | |||||||
Who is this dog for? |
Myself | ||||||
Why do you want a Pembroke? |
I have always loved corgis but never owned one of my own. I love how cute and happy they are. Every corgi I have met has been so sweet and I feel that they are good for me because I like to go on walks but I am not super fast walking and they would not be able to run very far very fast with their little legs. | ||||||
Activities planned with Pembroke: |
I would take my dog for walks and to play at the dog park. I would also play with my corgi all day and I work from home and have off over summer so I would have lots of time to get to know my corgi and play with them. | ||||||
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 not reward the negative behavior however I would try to correct it through positive reinforcement. If the dog is doing something that would require a break for the dog I would either take them outside or I would give them a break in their crate for a minute or two before letting them out again. | ||||||
Discipline: |
I would use positive reinforcement with kibble or small treats to show them what I like that they do. I would never hit my dog or use shock collars they are inhumane and it breaks my heart knowing dogs need to be rescued from those situations. I would always show affection for my dog and take good care of them and make sure than no matter what happens they are safe. | ||||||
Where would Pembroke spend the majority of the time: |
at home with me. If I am not home and gone for more than one hour I would either ask my neighbor to come play with the dog (they work from home too) or I would take my dog to | ||||||
Discipline: |
I would use positive reinforcement with kibble or small treats to show them what I like that they do. I would never hit my dog or use shock collars they are inhumane and it breaks my heart knowing dogs need to be rescued from those situations. I would always show affection for my dog and take good care of them and make sure than no matter what happens they are safe. Where would Pembroke spend the majority of the time: at home with me. If I am not home and gone for more than one hour I would either ask my neighbor to come play with the dog (they work from home too) or I would take my dog to |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, me. | ||||||
Where would dog eat? |
in the kitchen with me | ||||||
Where would dog sleep: |
on their bed which depending on the dog could be in a crate or out of the crate. If they wanted to sleep on my bed that would be fine I would get little doggy stairs for them. | ||||||
Play & exercise: |
We would go on daily walks and to the dog park for more running time if they need/want it | ||||||
How will you exercise your dog? |
Both on leash and restrained to the yard | ||||||
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: |
Rent/lease 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? |
Yes, you may contact my landlord. | ||||||
Lease allow dogs: |
Yes, my lease permits dogs. | ||||||
Landlord permission: |
Yes, my landlord is fine with me owning a Pembroke | ||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
My duplex has a small yard in the front and back of the house. The yard is not fenced in and I would only let the dog out in the yard with a leash on. I would take the dog to the dog park to run around. | ||||||
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? |
Emma Lynch | ||||||
Willing to train children? |
I do not have children, but I would make sure to take time to explain to children who ask about petting my dog. | ||||||
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. I would spend time with a dog trainer and work extensively to form a positive relationship between all pets. | ||||||
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} |