Date & Referral Source | |||||||
State: | {Applicant State:2} | Date of Application: | 01/01/2020 | Referred by: | Other | ||
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, Very Active |
Other preferences: |
We have two cats | ||||||
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? |
Mindy Bone and Derek James | ||||||
Why do you want a Pembroke? |
I love their over-the-top personalities. Their stubbornness can be a turn-off to some, but I find it to be very endearing. I have loved corgis since I was a child. I went with my mom to visit one of her old sorority sisters, who had a corgi named Robert, and I have been in love with the breed ever since. | ||||||
Activities planned with Pembroke: |
We would go on adventures and many walks, but would be sure to bring a doggie papoose for when their little legs inevitably get tired. We plan to go on a couple of camping trips a year as well. There will be lazy days hanging out at the house, but there is sizable fenced-in backyard anytime our corgi decides to get a case of the zoomies. | ||||||
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: |
Use a stern voice. Being that dogs are social beings they get the picture from voice tone. There is never any need for anything in the way of physical reprimanding. If voice tone fails, a good ol' trip to the crate for a few minutes should get the point across. | ||||||
Discipline: |
I know that positive association and reinforcements go a long way. As mentioned above, crate time could be an effective tool as well. | ||||||
Where would Pembroke spend the majority of the time: |
At home | ||||||
Discipline: |
I know that positive association and reinforcements go a long way. As mentioned above, crate time could be an effective tool as well. Where would Pembroke spend the majority of the time: At home |
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House dog or outside dog? |
House dog | ||||||
People at home during the day? |
I (Mindy) usually am. But, when I do have to be away at work I would make sure to come home on my lunch break to let the corgi out to go potty and stretch their legs. | ||||||
Where would dog eat? |
From bowls on the floor of our kitchen most likely. | ||||||
Where would dog sleep: |
With us in the bedroom | ||||||
Play & exercise: |
On walks/hikes. I have researched all the stores that allow dogs, so whenever possible the corgi would go everywhere we go. We also have a fenced in yard. | ||||||
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? |
It is a tall wooden privacy fence. | ||||||
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: |
|||||||
Landlord permission: |
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Restrictive covenants? |
Not applicable | ||||||
Breed/size restrictions? |
No | ||||||
Description of yard: |
An open yard with flowerbeds around the perimeter, a deck, and a shed. | ||||||
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? |
Mindy Bone | ||||||
Willing to train children? |
Of course! I’ve never been a fan of parents that allow their kids to pull on the fur of animals. It is also the perfect opportunity for a first lesson in the concept of consent and other's right to personal space. | ||||||
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? |
Absolutely! I could never abandon a being that I have a responsibility towards. I have seen good results from positive reinforcements. Such as, allowing them to eat near each other where they can smell one another, but with a screen between them until they are more comfortable around each other. | ||||||
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, marys@gmail.com, friend.:87} |