Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 07/07/2021 | 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: |
Outgoing, Playful, Energetic |
Other preferences: |
We are just looking for a friend to add to our family. We know that all dogs are different and have different needs. We've done our research on corgis specifically and know that they can be a high energy/ active breed and are prepared for that. | ||||||
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? |
The Pembroke would be for my family, myself, and most importantly my mom. I was fortunate enough to rescue my corgi earlier this year and my family and I absolutely fell in love with her. My mom is absolutely amazing with dogs and has helped me out so much with my dog and I would love to help her and my family rescue a forever friend of their own. My parents both work part time and have the time, energy, and love to commit to a furry friend at this point in their lives. Both of their children (Myself and my brother) are full grown and they (my parents) have both expressed interest in getting a dog. | ||||||
Why do you want a Pembroke? |
Again, I was fortunate enough to be able to adopt my own furry friend back in January. I have loved corgis and the breed for as long as I can remember. I and my family absolutely fell in love with waffles (my corgi) and I would love to help them find a friend of their own. I am finishing up nursing school and will be moving to Milwaukee which is why I am trying to help my parent find a pet. We have done a lot of research on the breed in preparation for rescuing my dog back in January and hav continued to do so with my dog just to learn more about her. My mom has been and absolute amazing help with her and we have had a lot of experience with the breed having had waffles for about 7 months now. | ||||||
Activities planned with Pembroke: |
We love going on walks as a family. We know that corgis can be a very active breed and love going outside and playing with her. Waffles absolutely loves fetch and because of that we have a lot of toys to accommodate that. We are also very close to water and a lot a great trails and have a lot of places and dog parks to take the dog too. | ||||||
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: |
Understand that dog makes mistakes and try and redirect. Adopting dogs and bringing them into a new home can be a lot for them and understanding that that takes time to adjust and just being patient. | ||||||
Discipline: |
We have had a lot of success with positive and negative reinforcement. We are big believers in rewarding positive/ good behavior and not rewarding negative/ "bad" behavior and we had a lot of success with the with our first corgi | ||||||
Where would Pembroke spend the majority of the time: |
With my parents. Both of my parents work part-time and are able to give some extra love and attention to a dog at this time. With their schedules, someone is usually always likely to be home with the dog which is really nice | ||||||
Discipline: |
We have had a lot of success with positive and negative reinforcement. We are big believers in rewarding positive/ good behavior and not rewarding negative/ "bad" behavior and we had a lot of success with the with our first corgi Where would Pembroke spend the majority of the time: With my parents. Both of my parents work part-time and are able to give some extra love and attention to a dog at this time. With their schedules, someone is usually always likely to be home with the dog which is really nice |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes | ||||||
Where would dog eat? |
In the kitchen, where their water and food bowel would sit | ||||||
Where would dog sleep: |
We have a medium sized dog crate at home that we could use for the dog and would also buy them a dog bed if we are fortunate enough to be able to adopt one. | ||||||
Play & exercise: |
We have a lot or dog parks in the area as well as a lot of neighbors and friends that own dogs. We have ample opportunities and areas in and around town to bring the dog for play and exercise. | ||||||
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 feet chain link 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: |
|||||||
Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We have a year that is surrounded by a 4 foot chain link fence. It is about 20-25 feet wide and maybe 40 long? (If I had to give my best guess). We do not have a book or anything like that in out backyard that would be an issue. | ||||||
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? |
Carolyn Werner | ||||||
Willing to train children? |
Yes, but we do not have any kids in the family or neighborhood so this should not be an issue! | ||||||
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} |