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Lost Nation Farm

Puppy Application

- Home Evaluation -

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Date:___________________

 

This questionnaire is prepared for your benefit, as the prospective owner, and the Lost Nation puppy that you plan to have become a part of your family. Please answer the following questions and return this form at your earliest convenience so that you can be placed on Lost Nation's puppy waiting list. It is important that you answer the following questions honestly and completely so we can best determine which puppy will be a suitable match for you and your home. Our puppies are given aptitude tests just for this purpose, and to work in conjunction with this questionnaire. We want you to be happy with your puppy, and for your puppy to be happy with you.

 

Please email colonel@wcomco.com for a Word version of this application.

 

Name:

 

Address: 

 

City

 

State & Zip: 

 

Phone:                                                               Email:

 

 

Occupation(s): 

 

 

Why do you want a Pembroke Welsh Corgi?

 

 

Have you ever owned a Corgi before?

 

 

If yes, when?

 

 

What variety?

 

 

Where did you get him/her?

 

 

What happened to him/her?

 

 

Who is this puppy for? (self, spouse, children, grandparents, etc):

 

 

 

If single, your age                     Live Alone?                   With Family?

 

If married, do you both work?

 

 

Husband’s/Wife's Hours:

 

 

How many children at home?

 

Ages:

 

 

Who will be responsible for the puppy, including it's care and feeding?

  

 

Do you rent?                

 

If yes, contact information for landlord:

 

Own a Home?

 

Apartment?

 

Are you moving?

 

If moving, when?

 

Where?

 

 

Does your lease allow pets?

 

 

Do you have a fenced yard?

 

 

If yes, how tall is the fence & how big is the fenced area?

 

Acreage?

 

How Much?

 

Is the dog to be fenced in or let loose?

 

Do you intend to keep the dog primarily indoors or out? Please elaborate:

 

 

 

Do you have a fence?

 

Type?

 

Height?

 

 

Is the fence secure and solid?

 

What types of gates?

 

Can children open the gates?

  

What types of improvements are needed to provide a secure yard?

 

Are you willing to make the improvements?

 

If you have a pool, is it fenced?

 

If you have a dog run is it secure?

 

Have you checked the yard for dangerous articles, plants, or anything the dog could use to climb the fence?

 

Are you aware of any distractions outside your yard that could disturb the dog? (Such as neighbor's dog, loose dogs on street, mischievous children) Please elaborate:

 

 

Can strangers gain access to your yard from the streets?

  

Do you or any family members have any pet allergies?  Please elaborate:

 

 

Do you have other pets?

 

What kind, gender & are they altered?

 

 

Where did you get your current pet(s)?

 

 

How long have you had him/her/them?

 

 

If you don't have a pet now, have you had a pet before?

 

 

What kind, and how long did you have them?

 

 

What happened to him/her/them?

 

If you have/had other animals, what have/has been your main problem with them?

 

 

If you have other dogs, would you consider them aggressive or submissive to other people?

 

 

to other animals?

 

 

If you have birds, rabbits, cats, etc., are you prepared to spend the time necessary to accustom them and the dog to each other?

 

 

Can you isolate the dog from the other animals if they cannot get along?

 

 

Are you willing to take time with the acquisition of a Corgi, read and learn all the facts of temperament, socialization, grooming and proper handling and understand the time required to own the breed?

 

 

Have you discussed with your family the pros and cons of owning a Corgi?

 

 

Have you asked yourself whether your lifestyle is so busy that you might not have the time or energy to properly care for a dog?

 

Is your lifestyle such that friends, relatives and children gain admittance to your home, property, and car without your supervision?

 

 

If you have children, are you willing to accept the additional responsibility of a Corgi?

 

 

Have you taught your children the proper way to treat a living animal?

 

 

Does everyone in your family want a dog?

 

 

What other breeds have you been contemplating?

 

 

 

What is your family's overall reaction to owning a dog?

 

 

Which members are most enthusiastic? Unenthusiastic?

 

 

What concerns have been voiced by other family members?

 

Are you aware that a Corgi is long lived breed of dog – they may live for 10-15 years? Are you committed to care for it that long?

 

A Corgi enjoys a daily walk, and, if properly conditioned, can go hiking or jogging with you. Have you and your family carefully considered how the dog would fit into your lifestyle?

 

 

If you expect to get a young dog, do you understand that early socialization is the key to developing a well-balanced adult dog?

 

Do you realize that socialization means taking your dog into crowded areas outside of your home and having strangers pet the dog?

 

That this period starts at about two months of age?

 

Are you willing to spend this kind of time?

 

 

Are you likely to enroll your dog in obedience training?

 

 

Are you willing to attend obedience classes to train the dog?

 

 

Which family members would be expected to assist with home training?

 

Do you intend to exhibit this Corgi in competition level obedience? (4-H counts)

 

Corgis are a working breed. What kind of work or behaviors do you expect of this dog?

 

Is this Corgi going to be doing herding work?

 

For competition, or work on a farm?

 

Is this Corgi going to be doing agility, flyball, or frisbee?

 

For fun, or competition?

 

Please name the most recent dog-training books you have read, or shows you have watched.

 

 

What amount of time and effort do you want to devote to training him/her?

 

 

What is your definition of disciplining a dog?

 

 

What is your initial reaction to the idea of disciplining your dog?

 

 

What are your training objectives?

 

Are you interested in showing your Corgi? If so, do you have any experience in this area?

 

Corgis excel in herding, obedience, tracking, and agility. Is this the type of showing that might interest you?

 

Are you thinking of breeding your Corgi?

 

Do you plan to spay or neuter your Corgi?

 

Do you have a gender preference?                   

 

Which?

 

Would you consider the opposite gender?

 

 

Would you be interested in an older dog?

 

 

Would you be interested in a rescued dog?

 

Would you be interested in a young adult/older puppy?

 

Are you agreeable to returning the dog, should some unforeseen circumstance arise wherein you would no longer be able to keep the dog? (required)

 

 

Would you be willing to allow us to visit your home?

 

 

How did you find out about Lost Nation Farm?

 

 

Color, sex and age preference in a Corgi:

 

Please list 3 references (required): name, address and phone number and relation, 1 must be a vet and 1 a neighbor:

 

1.

 

 

 

2.

 

 

 

3.

 

 

Signature:_________________________________________ Date:_____________________

 

Thank you for your cooperation. This comprehensive questionnaire helps us in placing the right dog with the right family. An improper placement, or one in which all the details aren't known, can end tragically, usually for the dog. We place dogs in forever homes, and we want the right fit for the right family.  Again, thank you.

 

Lost Nation Farm