Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 03/12/2022 | 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 | Gender preferred: |
Either a Male or a Female | Color preferred: |
Red & White, Red Headed Tri, Sable & White | Activity level: |
Couch Potato, Quiet, Playful |
Other preferences: |
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Dog Ownership History | |||||||
Previous dog owner? |
No | ||||||
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? |
This Pembroke is for myself, a 24 year old previous dog owner. | ||||||
Why do you want a Pembroke? |
I want to adopt a Pembroke Welsh Corgi because although I have not owned one myself, those I have been around seem to have a personality and energy level that would match my own. I also want to adopt a Pembroke Welsh Corgi because I live in an apartment which, although has a good about of space, would accommodate a small-medium sized dog well. My family has owned herding breeds in the past so I am well accustomed to keeping it busy and am aware of how quick they are to learn. I am also aware that Pembroke Welsh Corgis are good with other dogs, which will be great as during the school year, they will be spending days with a family member with a dog of their own. Having been part of a family that has owned dogs my whole life, I am well aware of the daily needs of dogs and believe that a Pembroke Welsh Corgi would be a great companion for my young adult life! | ||||||
Activities planned with Pembroke: |
I would take my Pembroke on walks and hikes. I will also take it to a family members home who has a large set of land and a dog for it socialize and run around. We will also sit on the couch watching tv/movies at the end of a busy day. | ||||||
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? |
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: |
It depends on the severity of the mistake. I would use a calm, but firm voice, saying, "No". And if the behavior continues, remove the dog from the location/situation and know to work on retraining to help reduce this behavior in the future. | ||||||
Discipline: |
I would redirect their attention from what they were doing and use positive language to reward good behavior. I would also possibly remove the dog from the situation and work on training for that specific behavior, so in the future the behavior doesn't reoccur. | ||||||
Where would Pembroke spend the majority of the time: |
Either at my apartment or a family members house (during the day) depending on the time of year. | ||||||
Discipline: |
I would redirect their attention from what they were doing and use positive language to reward good behavior. I would also possibly remove the dog from the situation and work on training for that specific behavior, so in the future the behavior doesn't reoccur. Where would Pembroke spend the majority of the time: Either at my apartment or a family members house (during the day) depending on the time of year. |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
During the school year, no. The dog will be taken to the family members house. During various breaks (winter/spring/summer), yes. | ||||||
Where would dog eat? |
In a open location of our kitchen/dining area. | ||||||
Where would dog sleep: |
In my bedroom with me. | ||||||
Play & exercise: |
The corgi would have many opportunities to play/exercise. The corgi will be at the family members house with a large yard that is partially fenced in. The corgi would be able to socialize with other dogs (possibly cats). I also live in a great location where we can go on walks and hikes around the area. The dog will also have space to play and items to play with in my apartment. | ||||||
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? |
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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? |
Yes | ||||||
Description of yard: |
I don't live in a house, but there is a significant amount of grass around my apartment that could be considered a shared yard. | ||||||
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? |
Maitlin Arts | ||||||
Willing to train children? |
I don't currently have children, but if my corgi is around children I will monitor how the children are interacting with it and intervene when necessary. | ||||||
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, I am willing to resolve any problems that occur between my corgi and other animals it comes in contact with. | ||||||
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} |