Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 12/22/2021 | 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: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Couch Potato, Outgoing, Quiet, Playful, Energetic |
Other preferences: |
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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? |
For our Family: Warren and Kristen, Paden (15) James (14) and current dog Teddy (7) |
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Why do you want a Pembroke? |
We are looking to add another dog to our household. Our boys are now old enough to take on more responsibility training and caring for the dogs, so we are letting them research dog breeds and help us choose what type of dog to get. They are very interested in Pembroke Welsh Corgi's. | ||||||
Activities planned with Pembroke: |
We love to go hiking as a family. We also love to just hang out at home and play and chill with our dogs. We have a fenced yard where we often play catch with our current dog. We have friends that own a lake home an hour away in Wisconsin and we spend many summer weekends at the lake. | ||||||
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: |
Depends on the mistake. Either redirecting them to a desired behavior or changing the environment or situation so that they can learn the appropriate behavior. | ||||||
Discipline: |
I firmly believe in positive reinforcement….over and over and over again….until the desired behavior is learned. | ||||||
Where would Pembroke spend the majority of the time: |
Free in the house with us, minimal crating if necessary only when we are not home. We crated our current dog for his first year or two, just at night and when we left the house, but he no longer needs to be crated. He is completely comfortable and well behaved when left alone for a reasonable amount of time. | ||||||
Discipline: |
I firmly believe in positive reinforcement….over and over and over again….until the desired behavior is learned. Where would Pembroke spend the majority of the time: Free in the house with us, minimal crating if necessary only when we are not home. We crated our current dog for his first year or two, just at night and when we left the house, but he no longer needs to be crated. He is completely comfortable and well behaved when left alone for a reasonable amount of time. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, pretty much all of the time. I do not work outside the home and my husband works from home. | ||||||
Where would dog eat? |
We currently have our dog's water/food dish in our laundry/mudroom. But he gets treats and chewies and is free to take them and eat wherever he chooses. | ||||||
Where would dog sleep: |
Initially in a crate, either in the Master Bath Ensuite or possibly in our kitchen. But eventually we allow our dogs to sleep where they wish. Sometimes in our bed or in one of the several dog beds we have located throughout our house. | ||||||
Play & exercise: |
Several times everyday. Especially with two teen boys in our house who love dogs. But I walk the dog once or twice a day and my husband and kids try to get one walk in a day, too…or at least some backyard playtime. We also have plenty of toys to play with inside. | ||||||
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? |
Wrought Iron fence, maybe 4 ft tall. | ||||||
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: |
Fully fenced in backyard with lots of trees. Two stone paved patios. | ||||||
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? |
Kristen Knowles | ||||||
Willing to train children? |
Yes, we already do this | ||||||
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, we have fostered a dog in the past so have had experience with this. | ||||||
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} |