Untitled_3859

Applicant IL
State: {Applicant State:2} Date of Application: 07/01/2021 Referred by: Website
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

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, Female, Either a Male or a Female
Color preferred:
 Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color
Activity level:
 Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active

Other preferences:

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}

Who is this dog for?

 I and Jeremiah Jack. Jeremiah Jack is my 5 month old Pembroke/Cardigan Corgi whom needs a partner in crime to keep me more busy.

Why do you want a Pembroke?
 My daughter had a Pembroke/boarder collie mix Corgi for years growing up and as an adult until he passed away a couple years ago. We miss Axel so much but it took a couple years before I found one again and now I'm ready for another too. I'm a empty nester and can have a couple little nuggets around for company to spoil and keep me super busy!

Activities planned with Pembroke:
 Traveling with them and lots of walks and lots of snuggles and tlc!

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?

 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: 		Verbal communication

Discipline:
 Repation

Where would Pembroke spend the majority of the time:
 Inside/outside with me

Discipline:
 Repation
Where would Pembroke spend the majority of the time: Inside/outside with me

House dog or outside dog?

 House dog

People at home during the day?
 Me

Where would dog eat?
 At home

Where would dog sleep:
 In bed with me or crate whichever he or she felt more comfortable with

Play & exercise:
 I have a huge yard with fenced portion and would take to Greenfield lake for walks

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?
 About 15% of yard is fenced for them to play and do what they want

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:

 No swimming pool ? We have a no dig fencing and we can make it bigger if need be. The yard is huge.

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?
 NA

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

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}