Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 05/29/2021 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years, 3 years – 5 years | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Playful |
Other preferences: |
We do have one dog, so we would need a corgi that gets along with other dogs. | ||||||
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? |
It is for our family! | ||||||
Why do you want a Pembroke? |
A big reason we are looking at a corgi is because we like the way they look, but as a breed they also have the right temperament we are looking for. We are looking for another smart, friendly dog to make our family complete! From what we have read corgis love to heard and stay busy, which is perfect for our mini Aussie. | ||||||
Activities planned with Pembroke: |
Just about everything we can do! We love to take our Aussie on walks, as well as to the park. We have a nice fenced in yard they can play in or just lounge around all day in the sun. We like to go for hikes, camping, and go tubing down the river also. | ||||||
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: |
Animals make mistakes, we just try to be encouraging. We let them know what they did was wrong, but make sure they know it will still be okay. | ||||||
Discipline: |
When our Aussie is naughty we calmly let her know what she did was wrong, and initiate corrective action if necessary. She seems to respond well to us talking, but if she is barking too much or something we just say "hey, no barking" and typically that is enough. | ||||||
Where would Pembroke spend the majority of the time: |
Outside as much as they want, inside the rest of the time. Our dogs are welcome to free roam the house besides the basement. | ||||||
Discipline: |
When our Aussie is naughty we calmly let her know what she did was wrong, and initiate corrective action if necessary. She seems to respond well to us talking, but if she is barking too much or something we just say "hey, no barking" and typically that is enough. Where would Pembroke spend the majority of the time: Outside as much as they want, inside the rest of the time. Our dogs are welcome to free roam the house besides the basement. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, one of us is always home. | ||||||
Where would dog eat? |
They would eat in the kitchen unless there is a spot that they prefer. | ||||||
Where would dog sleep: |
We have a dog bed they can use or they are welcome on furniture/ in the bed. | ||||||
Play & exercise: |
We have a large fenced in yard they can play in as much as they would like! We also go for at least one walk a day, two if we get the time. Our walks usually last at least half an hour. There are also several dog parks in the area, as well as hiking trails we frequent. | ||||||
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? |
It is a chain link fence that stands roughly 4.5 to 5 feet high. It is secured all the way around with no holes or missing sections. | ||||||
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: |
Our house has a fully fenced in L shaped back yard with mo fixtures. It is just the grass! | ||||||
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? |
Michaela | ||||||
Willing to train children? |
If we have a child in the future, we are more than willing to teach them how to love animals. | ||||||
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, of course! | ||||||
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} |