Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 02/18/2022 | 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, 5 years – 10 years | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Playful |
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? |
myself | ||||||
Why do you want a Pembroke? |
I have not had a Pembroke, but I had rescued a Cardigan several years ago. I am looking for a good match for Lucy, my beagle. Lucy is a stray rescue. She loves all dogs, so I am not breed specific in adopting…they just have to have a good disposition. Pembrokes are known for their happy go lucky attitudes, that appeals to me.
I have a grand-pup who visits frequently. She is a boxer mix, but is a little timid around bigger, alpha dogs. So it is important to me to find a good match there. She is my girl and loves coming to Gramma's! |
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Activities planned with Pembroke: |
I live on 2.5 acres (fully fenced) so the dogs have a large yard to play in. In addition to that, during good weather, Lucy and I walk three times a day. Lucy gets car sick, so we make short trips in the car. We have a large park near us and going to watch the ducks is a favorite of her's. | ||||||
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: |
Remain calm. We all make mistakes! | ||||||
Discipline: |
Lucy is stubborn, as Pembroke's can be. I firmly tell her no and then redirect until her mind has "let it go" | ||||||
Where would Pembroke spend the majority of the time: |
With me in the house, or outside. I am retired and am never gone from the house for more than a few hours. I do crate Lucy when I am gone. At night, she sleeps in the bed with me. | ||||||
Discipline: |
Lucy is stubborn, as Pembroke's can be. I firmly tell her no and then redirect until her mind has "let it go" Where would Pembroke spend the majority of the time: With me in the house, or outside. I am retired and am never gone from the house for more than a few hours. I do crate Lucy when I am gone. At night, she sleeps in the bed with me. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, me | ||||||
Where would dog eat? |
In the kitchen | ||||||
Where would dog sleep: |
If they desire in my bed. At the very least in the bedroom. I sleep with my door closed so I would not want a dog not to be able to get to me. | ||||||
Play & exercise: |
As mentioned, I live on 2.5 acres. And daily walks. Daily exercise is not an issue for my dogs. | ||||||
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? |
Fully fence with a combination of fencing 6' privacy 4' farm fencing 4' aluminum |
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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: |
Fully fenced yard, I do have an inground pool | ||||||
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? |
Joanie Rogers | ||||||
Willing to train children? |
My children are adults, but should I ever get grandchildren, 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? |
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? |
Kiki is a feral and terrified of dogs. She is protected upstairs in a separate room and Lucy can only get up there when I allow her too. Kiki only reacts if Lucy gets too close. Which Lucy has learned to give Kiki her space. | ||||||
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} |