Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 04/27/2021 | 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: |
Sable & White | Activity level: |
Outgoing, Quiet, Playful |
Other preferences: |
I have just lost my lab in Se2020. She was my best sidekick for over 7 years. Miss her and all our walks. Need to share more furry love. | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
Yes | ||||||
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? |
The Corgie would be for me | ||||||
Why do you want a Pembroke? |
I have always loved the breed and the way they behave. I love their face and their size and personality Being a Royals fan and love watching the Corgies on all the shows. I have fall in love . I am retired and a widow living by myself in my own home. Over 43 years we have had a variety of breeds from Shelties, Old English, Black Lab and Yellow Lab. Well now I n.eed a small size cutie for walking, snuggling and listen to me go on and on aboshoput everything. I do have 2 amazing cats and a gaggle friendly oudoor critters. | ||||||
Activities planned with Pembroke: |
Walking, traveling, snuggling, visiting at my volunteer pet rescue . | ||||||
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: |
Correct the dog calmly and then reinforce the correct way | ||||||
Discipline: |
Love and reinforce the correct way in a calm and strong manner | ||||||
Where would Pembroke spend the majority of the time: |
With me most of the time. I only leave to visit a friend, doctor or errand. I hav edog beds n my bedroom and living room and a fenced in yard. | ||||||
Discipline: |
Love and reinforce the correct way in a calm and strong manner Where would Pembroke spend the majority of the time: With me most of the time. I only leave to visit a friend, doctor or errand. I hav edog beds n my bedroom and living room and a fenced in yard. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Just me | ||||||
Where would dog eat? |
in the kitchen | ||||||
Where would dog sleep: |
In my bedroom in a dog bed | ||||||
Play & exercise: |
I live onthe river and across the river from huge city park, accessible from my houseby a 3 block walk, Mishawaka also has a wonderful dog park ( off the leash ) 2 miles from my home | ||||||
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? |
5 foot chain link fence across my back yard | ||||||
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: |
|||||||
Landlord permission: |
|||||||
Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
I live on the St. Joe river. my back yard is on the river except for the fenced partial yard. | ||||||
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? |
Linda Decatur | ||||||
Willing to train children? |
The children would be the ones who probably want to pet the Corgie for their cutness and personality. Yes I am so willing to teach children to be nice to the dog with proper distancing and petting | ||||||
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. My cat loved my Lab and cared when Katie got sick. | ||||||
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} |