Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/07/2022 | 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: |
Any age | Gender preferred: |
Either a Male or a Female | Color preferred: |
Any color | Activity level: |
Outgoing, Playful, Energetic |
Other preferences: |
I currently have a rescued female Shiba, (Tara)–who is approximately 13-14 years old. She is still relatively active and I walk her often. She is shy and timid but really enjoys other dogs. I recently lost my 17 year old Shiba who was an Alpha and while they got along , Tara does well with other dogs who are more "happy go lucky" and not overly aggressive. I'm a very active person so I tend to be very active with my dogs | ||||||
Dog Ownership History | |||||||
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} | ||||||
Questions Regarding Motivation for Adopting and Intentions | |||||||
Who is this dog for? |
myself | ||||||
Why do you want a Pembroke? |
I love that they are smart, playful and a bit stubborn. I know they can range from high energy but are also can be cuddly. I like they are working dogs and enjoy having a job. They are loyal and for the most part enjoy their person or family. While I don't have experience specifically with Corgis I grew up on a farm where I was exposed to dogs all my life. Everything from German Shepherd, to Saint Bernard, Rat Terriers and most recently my Shiba Inus. | ||||||
Activities planned with Pembroke: |
I walk my Shiba Inu A LOT, so I would enjoy doing the same with a Corgi. I would enjoy taking him/her to the dog park, playing ball and other activities in the park, socializing with others, etc. | ||||||
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: |
I would redirect them and try to identify why the mistake has happened? Have they not had enough interaction, stimulation, etc? | ||||||
Discipline: |
In the past I have used a different name and the "time out" location was his crate. | ||||||
Where would Pembroke spend the majority of the time: |
Generally with me and my husband. My husband works remotely so he is home most of the time. I would attempt to crate train so when no one is home they might be crated–although that depends on a lot of factors. One of my Shiba's was crate trained, my rescue is not as she is terrified because of her experience in the awful puppy mill. | ||||||
Discipline: |
In the past I have used a different name and the "time out" location was his crate. Where would Pembroke spend the majority of the time: Generally with me and my husband. My husband works remotely so he is home most of the time. I would attempt to crate train so when no one is home they might be crated–although that depends on a lot of factors. One of my Shiba's was crate trained, my rescue is not as she is terrified because of her experience in the awful puppy mill. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
Yes, almost always | ||||||
Where would dog eat? |
Again this would depend on if the Corgi had food guarding behaviors since I have another dog (who doesn't guard her food). If there are food guarding issues, it is likely the Corgi would be feed in a separate room off of the kitchen. | ||||||
Where would dog sleep: |
We are flexible on the sleeping arrangements–again just depends on the dog's disposition. If it is crate trained possibly the crate, if not it would have multiple options in the house. We have multiple dog beds throughout the house and our current Shiba sleeps in a variety of locations. We do not mind the dogs on the sofa or elsewhere–so we would base this decision on disposition of the dog | ||||||
Play & exercise: |
I walk my current Shiba at least 4 times a day during the week and more during the weekend. We live very close to multiple parks, including dog parks so I would entertain taking the Corgi to the dog park. I am a highly active person so I would exercise the dog as much as possible. | ||||||
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? |
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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: |
|||||||
Restrictive covenants? |
No, the condo covenants do not prevent me from having a dog. | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
We live in a condo with a walk out basement. | ||||||
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? |
Me-Rene Kougel | ||||||
Willing to train children? |
Our children are adults with no children. We do not really have anyone is our lives that have small children. | ||||||
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? |
Of course. We would be committed in obtaining assistance in this area if needed; although we have experience in this area. | ||||||
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} |