Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 04/25/2021 | 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: |
3 years – 5 years, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Playful |
Other preferences: |
I live with my step daughter and she has two rescues. One large and one small. My two corgis lived happily with them for 4 years. | ||||||
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? |
ME. For the past 15 years I have had two pem girls. One lived to be 15 and the other 14.5. They died of cancer and kidney failure respectively. I lost Maeve in October and Aine three weeks ago. | ||||||
Why do you want a Pembroke? |
I do love the breed. As noted I have had pems for 15 years and I am one of three founders of the Midwest Corgi Picnic, the other two being my deceased spouse and a friend. We are an annual fundraiser for Corgi Aid and Bandits Bandaid. I love how they look. I love how smart they are. I love how funny they are. Some are more cuddly than others. I loved my sassy, bossy little girls. My alpha female kept our large pit mix in line. He did whatever she told him to do. I miss her terribly. |
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Activities planned with Pembroke: |
Play ball, play with water if they liked it. Long walks and playing in my stepdaughters large fenced yard. I live with her. Take her/him to the Corgi picnic and local corgi meetups. I have many corgi friends. He/she would go wherever I go. I am retired. I understand this working, herding breed and could give them a great home. | ||||||
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: |
A mistake is no big deal. I would not yell or get upset. | ||||||
Discipline: |
Positive reinforcement. Treats but not too many as corgis are highly food motivated and tend to gain weight. Professional training if needed. | ||||||
Where would Pembroke spend the majority of the time: |
with me in the house or the car or out playing. | ||||||
Discipline: |
Positive reinforcement. Treats but not too many as corgis are highly food motivated and tend to gain weight. Professional training if needed. Where would Pembroke spend the majority of the time: with me in the house or the car or out playing. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I am always home. | ||||||
Where would dog eat? |
in their crate – all our dogs eat in crates. | ||||||
Where would dog sleep: |
wherever they wanted – in my bedroom, in my bed or in their crate as they choose. | ||||||
Play & exercise: |
We have a large fenced in yard and I would walk her/him at least twice a day. Arrange play dates with other corgi friends. Talk walks in parks and woods. | ||||||
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? |
6ft. privacy fence | ||||||
Living arrangements: |
live with my stepdaughter in private 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: |
No pools. Very large fenced yard. We have a fire pit. We also have a small 4 ft inflatable pool in the summer for the dogs and my grandson who is 9. | ||||||
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? |
Joni Wamer | ||||||
Willing to train children? |
No children live here. My nine year old grandson adores my stepdaughters dogs and he loved my corgis and they loved him. | ||||||
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? |
Absolutely. In any way possible. | ||||||
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} |