Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 07/02/2021 | Referred by: | Friend, Other | ||
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) | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Playful |
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? |
This Pembroke is for Aidan Reyes and Yesenia Montes. A mother and son who have been wanting and searching for a pembroke for a very long time | ||||||
Why do you want a Pembroke? |
We want to adopt a Corgi because we've been looking for dogs to adopt for about a year now and have been having trouble in deciding which breed we want to get. We found that Corgis best fit our time schedules and run with our time better than any dog. We know that Corgis are high maintenance dogs and require alot of attention, we're also aware of their shedding periods throughout the years, plus we learned about the issues that come with training and potty training. We've also asked other family members/friends who have Corgis what it's like to take care of/raise them and have educated ourselves on that as well | ||||||
Activities planned with Pembroke: |
Hiking, Walking, Runs, ETC. We want to be active more so we think having this dog would be great for us! | ||||||
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? No |
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Do you have a veterinarian? |
No | ||||||
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: |
Training. Simple. | ||||||
Discipline: |
Be consistent, calm, no screaming, yelling, hitting. Time-outs and being firm assertive but also making sure to not scare them or put them in a place of fear is my biggest goal | ||||||
Where would Pembroke spend the majority of the time: |
Inside most of the time unless we're going for a walk, playing, or to taking a bathroom break. | ||||||
Discipline: |
Be consistent, calm, no screaming, yelling, hitting. Time-outs and being firm assertive but also making sure to not scare them or put them in a place of fear is my biggest goal Where would Pembroke spend the majority of the time: Inside most of the time unless we're going for a walk, playing, or to taking a bathroom break. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes. The only time the Pembroke would be completely alone is on Mondays and Wednesdays for about 6 hours. We have a routine set up for that already though. | ||||||
Where would dog eat? |
Kitchen | ||||||
Where would dog sleep: |
Teenagers room with it's own bed and/or crate | ||||||
Play & exercise: |
We have a park near our home that's dog friendly and filled with opportunities for our Corgi to have a lot of free time and fun. We also would use carriers ti carry our dog around on hikes or long walks. We feel prepared to properly care for this breed. | ||||||
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? |
Very sturdy, high, wood and metal fence. About 8 Feet tall. Wooden fence guarded with a metal double fence. | ||||||
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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
It's an open backyard. It's all concrete and brick. The only dirt is a small section in a corner where we grown some flowers but other than that its just some chairs a table a swing and a grill. | ||||||
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? |
Yesenia and Aidan | ||||||
Willing to train children? |
Of course! | ||||||
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. Although Daisy loves everyone she meets we're willing to train both dogs to where they can adapt to being with each other | ||||||
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} |