Untitled_4079

State: {Applicant State:2} Date of Application: 12/22/2021 Referred by: Other
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

Ages interested in:
1 year – 3 years
Gender preferred:
Male, Female, Either a Male or a Female
Color preferred:
Any color
Activity level:
Playful

Other preferences:

Previous dog owner?
Yes
 
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}

Who is this dog for?

Myself

Why do you want a Pembroke?
Very smart breed, love their energy. My friends and roommate has had this breed and we always got along. Super smart, trained it to fetch in a single day. I have done my research on the breed and am confident that I can provide a great home. Only questions and concern I have is regarding pricing.

Activities planned with Pembroke:
Walking, Running, Playing, Socializing.

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:
Immediately express displeasure with a loud No or Noise and redirect the dog.

Discipline:
Distract with a loud noise or no
Lightly push them onto their back
Ignoring them after acknowledging the mistake
Redirect them to Sit and Wait


Where would Pembroke spend the majority of the time:
At home and around the neighboring dog park (.3 miles away) or the local trail / park (walking distance)

Discipline:
Distract with a loud noise or no
Lightly push them onto their back
Ignoring them after acknowledging the mistake
Redirect them to Sit and Wait
Where would Pembroke spend the majority of the time: At home and around the neighboring dog park (.3 miles away) or the local trail / park (walking distance)

House dog or outside dog?

House dog

People at home during the day?
Yes, remote worker. Only away about 14 hrs a week.

Where would dog eat?
In my kitchen / dining area

Where would dog sleep:
At first in the crate in my bedroom

Play & exercise:
Many walks / runs around the neighborhood as well as social visits to neighbors with pets. Good play at home as well.

How will you exercise your dog?
Both on leash and restrained to the yard

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?
Yes, you may 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?
Not applicable

Breed/size restrictions?
No

Description of yard:

No House

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?
Self

Willing to train children?
No kids

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?
No other pets but yes If I do plan on another pet I would

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, [email protected], friend.:87}