Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 09/07/2021 | 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: |
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years | Gender preferred: |
Male | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Energetic |
Other preferences: |
We have a 3.5 year hound(?) mix rescue who is still very playful. Her next brother Corgi should be dog friendly too. | ||||||
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? |
Me (Jennie) and Dan. Our family. 🙂 | ||||||
Why do you want a Pembroke? |
We would like to adopt a Corgi because we love their personalities. They have big dog attitude in a cute little package. They are smart, funny/quirky, a bit bossy/needy but loves people (and snacks). We had a corgi mix who was all of these things. | ||||||
Activities planned with Pembroke: |
Long walks/hikes. Training/Rally. Sheep/duck herding (tried it w/ my prior corgi and he didn't like it so we gave it up. Really depends on the dog). Cuddling on the couch/bed. | ||||||
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: |
We have older dogs that have rather frequent potty mistakes. It's something we manage (frequent potty breaks) but when they happen usually we say the dogs name (BOSLEY!) and then clean it up and take them outside. We have hard floors for a reason! If Molly picks up something she shouldn't – we redirect her to give it to us and then she gets a treat. If Molly barks out the window – she's redirected and told to go to her bed instead of continuing to bark out the window. | ||||||
Discipline: |
Time out. | ||||||
Where would Pembroke spend the majority of the time: |
In the house w/ us! | ||||||
Discipline: |
Time out. Where would Pembroke spend the majority of the time: In the house w/ us! |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes – I have a remote-only job and my husband is mostly work-from-home. | ||||||
Where would dog eat? |
Kitchen. All dogs are separated and we monitor everybody. Nobody is allowed to bully another dog from their bowl. | ||||||
Where would dog sleep: |
Master bedroom with everybody else! | ||||||
Play & exercise: |
Leash & fenced yard – lots of walks/hikes/training. Although I will say – our corgi mix did not like to play ball in the yard – he wanted to play ball in the house. So we let him run up/down the long hallway. | ||||||
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? |
4ft aluminum (bars). Self-closing gate opens inwards (harder for dog to pull open a gate – avoids the nudge open issue). | ||||||
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: |
Ranch w/ unfinished basement. Hard floors (wood/tile) throughout because we are dog people. Back yard is fenced but there is a raised deck to get to it (for older dogs we use the front yard to avoid stairs – so they are constantly leash walked). Raised deck has wood lattice around it to prevent animals (rabbits etc) from going underneath but we have a door access to under the deck and can easily move around under the deck if necessary. | ||||||
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? |
Jennie | ||||||
Willing to train children? |
Yes | ||||||
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 – Molly is scared about most dog intros (she had bad experience in the neighborhood when she was young). We expect a new addition to take time for everybody to adjust. I (Jennie) have had dogs that did not get along – they were separated into different groups. | ||||||
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} |