Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 05/13/2021 | 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? |
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? |
myself | ||||||
Why do you want a Pembroke? |
I currently have a corgi. I was first familiar with the breed from a friend who has had several. I started looking for a rescue corgi in 1991 (had several other rescues in between) and FINALLY found a 5 year old female in 2014-the day after I lost my Springer (rescued at 10 yo) I beat out 85 other responses (Craigslist!). She had been supposedly in a tornado in TN and ended up at the Dbq, Ia shelter, adopted by someone who went around to pet stores on behalf of a food co., she had her for 3 months and was "allergic" So I called my corgi friend, we went 30 minutes north to meet this corgi. Come to find out my friend had gotten one of her corgis from this lady-she had been a corgi breeder and was now into designer dogs. My friend remembered her and had gotten her corgi b/c he wasn't "show quality". Anyway I brought Zoey home-according to her records from the Dbq, IA shelter, she was a 5 yo spayed female. I have had 6 1/2 wonderful years with her when she developed a lump on her face. The vet treated her with antibiotics for an abscess, she didn't respond, so the vet wanted to pull her tooth. I got a call during surgery It didn't look good (I'm crying as I type this.) Her biopsy from Iowa State vet school came back positive. It would be at least 4 weeks before they could see her and at least an initial $6K. We're 2 weeks down now and she is losing ground fast. I'm trying to prepare for the inevitable-each dog gets harder and Zoey holds a big spot in my heart. I've talked to other friends who have lost dogs to oral cancer and researched online, so I know it's a very fast moving cancer. While I don't want to bring a dog home right now for her sake, I do want another corgi. They are so smart and lovable and funny. Which is why I am submitting an app now. |
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Activities planned with Pembroke: |
My back yard is completely fenced and backs up to a middle school and one of the largest 4 parks in town. Currently (even after diagnosis), we walk twice a day, although our walks have gotten shorter. She knows most of the school staff behind me and they are constantly asking about her and praying for her. She also has a following of kids at the school who sit and pet her (with covid, they have been outside more to burn off energy and we walk about the time they're outside). In her younger days, she used to herd the geese back to the lagoon at the park and loved finding lost tennis balls by the tennis courts. She's also well acquainted with a lot of park staff. I am also a long time volunteer for our dog parks and the annual dog swim (when they close the pool for the season, the dogs get to swim that weekend). She has also traveled to IL when my son lived there and enjoyed the dog beach at Lake Bluff, he now lives in WI, so we visit there. And of course, back in her younger days, the endless hours of throwing the tennis ball thru the house or in the back yard, chasing squirrels and rabbits and just chilling in her OWN chair by the picture window. | ||||||
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: |
get the corgi on a bathroom schedule (assume that's the "mistake?") Realize accidents happen, clean it up good to remove the scent, take him/her out more often | ||||||
Discipline: |
do not yell/raise voice, kindness and redirection, keep corgi well exercised to head off any boredom issues, plenty of toys ( I have tons of toys from having had so many dogs-each one has their favorites) | ||||||
Where would Pembroke spend the majority of the time: |
would be an inside dog and depending on weather (and yes, I have corgi coats-they're not easy to fit!) we'd be outside. I never leave Zoey alone outside-I may be in the front yard while she's in the back yard or tending to my garden on the side. My house is on a corner and with the school and park so close, I stay close by/within earshot. As I mentioned she has her own chair-a foam washable chair with no legs-(I believe it's a teen/kid chair from like Pottery Barn a find from Salvation Army) so she can watch out the window or sleep. There is a toy box and a comforter to lay on in the living room and a dog bed in my bedroom. | ||||||
Discipline: |
do not yell/raise voice, kindness and redirection, keep corgi well exercised to head off any boredom issues, plenty of toys ( I have tons of toys from having had so many dogs-each one has their favorites) Where would Pembroke spend the majority of the time: would be an inside dog and depending on weather (and yes, I have corgi coats-they're not easy to fit!) we'd be outside. I never leave Zoey alone outside-I may be in the front yard while she's in the back yard or tending to my garden on the side. My house is on a corner and with the school and park so close, I stay close by/within earshot. As I mentioned she has her own chair-a foam washable chair with no legs-(I believe it's a teen/kid chair from like Pottery Barn a find from Salvation Army) so she can watch out the window or sleep. There is a toy box and a comforter to lay on in the living room and a dog bed in my bedroom. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
yes-all day | ||||||
Where would dog eat? |
food and water bowls in the kitchen, treats by the door | ||||||
Where would dog sleep: |
corgi's chair, comforter in the living room or dog bed in the bedroom | ||||||
Play & exercise: |
at least 2 walks a day at the park, time in the fenced back yard and playing both outside and in the house | ||||||
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? |
4 foot chain link entire 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: |
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Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
70X110, flat no pool,hot tub etc, nothing to get into | ||||||
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? |
me | ||||||
Willing to train children? |
My grandkids are great with dogs, they live In WI, so not around a lot. They are older. between 13 and 19. The kids at the school behind me (middle school 6-8grade) are respectful of dogs and usually always ask to pet and thank me after. | ||||||
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, but I am pretty much a 1 dog person | ||||||
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} |