Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 08/05/2021 | 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: |
1 year – 3 years, 3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color | Activity level: |
Outgoing, Playful, Energetic |
Other preferences: |
(Don't see another place so far.) We have two smallish mixed-breed dogs, three cats, and two domestic, indoor rabbits. The rabbits are in cages away from the dogs. | ||||||
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? |
Oleta loves Corgis more. Bruce will get most of the feeding, walking, taking to vets. Oleta gets brushing, talking to, some playing with. |
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Why do you want a Pembroke? |
Good experiences with the three we had. (fyi, adopted as puppies, Lynn Brooks of Wisconsin Rapids, WI, beeder.) Like the smarts, smiles, friendliness. We researched the breed before our first (1987). Read two books on the breed. Reading more recently on internet. |
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Activities planned with Pembroke: |
Long and short walks, play (mostly indoors). Talking to (our first tried to imitate our English; the only word that stuck was "aooo", meaning, "Take me outside"). Training as needed. |
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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: |
Varies by type of mistake. Usually starts with a firm NO. (Not screamed.) Maybe make a point of righting the thing that was knocked over, or cleaning the mess. In some cases, pick the dog up and move away. Once the mistake is over and effects taken care of, make sure the dog gets hug or other loving. Some things, like a dog takes carrots out of a grocery bag and eats them, you just have to let nature take its course. Don't panic. |
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Discipline: |
firm No, crating, keeping away from situation where an active dog is not wanted (eg, a yoga class over internet). Pulling back from an animal which is not comfortable with the interaction. In special cases a gentle swat on muzzle or leg might point out the issue. |
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Where would Pembroke spend the majority of the time: |
In house. Exactly where will depend on how things are going. Free-range/ in a big cage/fenced in one room/in a bathroom if bad diarrhea. | ||||||
Discipline: |
firm No, crating, keeping away from situation where an active dog is not wanted (eg, a yoga class over internet). Pulling back from an animal which is not comfortable with the interaction. In special cases a gentle swat on muzzle or leg might point out the issue. Where would Pembroke spend the majority of the time: In house. Exactly where will depend on how things are going. Free-range/ in a big cage/fenced in one room/in a bathroom if bad diarrhea. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Except for 9-12 Sunday morning, there is someone around almost all the time. Bruce is working from home still; that might last until 12/31 retirement. |
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Where would dog eat? |
The current dogs eat in the dining room (not at the table). I hope relationships work smoothly that new corgi can have a food bowl in her/his own corner. If there are startup issues, we can feed corg in a cage or the kitchen with door to dining room closed. | ||||||
Where would dog sleep: |
Partly the dog's preference. There is a dog bed and a folded bedspread on floor of first floor. Our previous corgies spent most nights on our bed. We will have to be careful to prevent jumping down. | ||||||
Play & exercise: |
The first floor is fairly big, with a circle path. We have a few toys for fetch or carry off. We hope the active jackabee (jack russel/beagle) and the corgi will find games they like. (The chiwienie (Chihuahua /dachshund) is a couch potato. | ||||||
How will you exercise your dog? |
On leash | ||||||
Fenced yard? |
No, I don’t have a fenced in yard. | ||||||
Willing to pick up dog waste? |
Yes, I will clean up after my dog. | ||||||
Willing to use a crate? |
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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: |
Front yard is not huge. Substantial flower beds. If a dog wakes me up in early morning needing an out, it is plenty big enough for the dog to deal with the emergency. The back yard has lots of plants of various sizes. It is not a practical place for dog walks. |
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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? |
walking/feeding-Bruce; grooming-Oleta. | ||||||
Willing to train children? |
Two of our grandkids live with dogs already. We can work with the third when he visits. | ||||||
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? |
No, some of our current pets are not friendly toward dogs | ||||||
Are you willing to work on it if your new dog doesn’t get along with your current pets right away? |
(Previous Q: the cats accept the dogs but are not buddies. The rabbits want to stay away from dogs and are kept penned away from the carnivors.) Yes. We will work with the issues that arise. |
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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} |