Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 09/21/2021 | Referred by: | 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: |
3 years – 5 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Red & White, Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Other (Please describe in the box below.) |
Other preferences: |
Needs to be dog friendly, I can bring my corgi to work where there are three, sometimes four other small dogs! | ||||||
Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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} | ||||||
Questions Regarding Motivation for Adopting and Intentions | |||||||
Who is this dog for? |
Me | ||||||
Why do you want a Pembroke? |
I love how corgis look and I love how fun they are!! My brother who is my room mate especially loves corgis, our uncle in texas has two of these fun dogs and every year we adore these pups!! Yes I have done research on them 🙂 | ||||||
Activities planned with Pembroke: |
Every morning I go on walks for an hour or two, and when the weather is nice I walk to work where the corgi can come with. | ||||||
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? |
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: |
If it’s caught makeing a mistake, I will correct them by sharply saying NO. And rewarding good behavior | ||||||
Discipline: |
Say NO, or ignore bad behavior. I will only reward good behavior with treats and affection | ||||||
Where would Pembroke spend the majority of the time: |
In the office with me while I’m at work 🙂 | ||||||
Discipline: |
Say NO, or ignore bad behavior. I will only reward good behavior with treats and affection Where would Pembroke spend the majority of the time: In the office with me while I’m at work 🙂 |
||||||
House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, my brother lives with me..he LOVES corgis!
At my office there are three other men who work here, we all typically stay in our own offices. and occasionally customers come in with their kids (youngest kids we have here are 12) so the pup needs to be good with strangers and good with older kids |
||||||
Where would dog eat? |
In the kitchen | ||||||
Where would dog sleep: |
In my room on his own bed, or on my bed. | ||||||
Play & exercise: |
Walks every day! And once or twice a week me and my best friend go hiking with her dog!
I’m also happy to go to dog parks if needed, my apartment has a dog park. |
||||||
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? |
|||||||
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? |
No, you may not 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? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
Yes | ||||||
Description of yard: |
I don’t have a yard, but my apartment complex does have a dog park, theres also a pretty awesome dog park near me as well I want to go to of needed! I have a big deck too 🙂 | ||||||
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? |
Allie James (me) | ||||||
Willing to train children? |
Yes when I have kids I will walk them threw | ||||||
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? |
Izzy has a love hate relationship with dogs, if one gets to close she will nip their nose! That’s about it though, I try to not let dogs to close to her. | ||||||
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} |