Untitled_1366 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	08/29/2017	Referred by:	Other
Contact Information
First name:		Last name:		First name 2:		Last name 2:
Address
Street:
City:			State:		Zip:
Type of Dog Wanted
Ages interested in:	Any age	Gender preferred:	Male	Color preferred:	Red & White	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic
Other preferences:	The Pembroke I would adopt would have to be good with children. Even though I have no children or grandchildren, there are children in the neighborhood who loved my corgi Gizmo and would stop by just to visit him. I also live two blocks from an elementary school.
Dog Ownership History
Previous dog owner?	Yes
	Dog 1
	Dog 1 name:
	Dog description:
	How long owned?
	Where is this dog now?
	Dog 2
	Dog 2 name:
	Dog description:
	How long owned?
	Where is the dog now?
	Dog 3
	Dog 3 name:
	Dog description:
	How long owned?
	Where is dog now?
	Dog 4
	Dog 4 name:
	Dog description:
	How long owned?
	Where is this dog now?
Questions Regarding Motivation for Adopting and Intentions
Who is this dog for?	This Pembroke is for myself.
Why do you want a Pembroke?	I recently lost my 12-year old corgi Gizmo. I love the corgi's personality, their big ears, smiling face, short legs and stubby tail. I think they are the cutest dogs on the planet!
Activities planned with Pembroke:	I would probably walk my corgi at least twice a day, and probably take him to the dog park frequently to run and play. I also have a fenced-in yard so that he could explore outdoors.
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
Do you have a veterinarian?	Yes
Vet contact info:
Will handle mistakes Pembroke makes like this:	I would use a firm NO, remove the dog from the situation, and/or use treats to modify their behavior.
Discipline:	I would correct them with a firm voice or use treats or rewards to train them.
Where would Pembroke spend the majority of the time:	My Pembroke would spend his time in my house or out walking or in my fenced-in yard or at the dog park.
Discipline:	I would correct them with a firm voice or use treats or rewards to train them. Where would Pembroke spend the majority of the time: My Pembroke would spend his time in my house or out walking or in my fenced-in yard or at the dog park.
House dog or outside dog?	House dog
People at home during the day?	Because I am retired, I am at home during the day.
Where would dog eat?	My adopted corgi would eat in the kitchen.
Where would dog sleep:	My adopted corgi would sleep next to my bed in a dog bed or in a kennel if that's what he would prefer.
Play & exercise:	I would walk my corgi twice a day, let him run in my fenced-in yard, and take him to the dog park frequently.
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?	I have a 4-foot high chain link fence with a gate at the front and a gate at the back.. It measures about 18 feet by 36 feet.
Living arrangements:	Own home
Landlord info:
May we contact your landlord?
Lease allow dogs:
Landlord permission:
Restrictive covenants?	Not applicable
Breed/size restrictions?	No
Description of yard:	I have a smallish front yard and a deep back yard with no pool and a line of evergreens at the back of the property.
Household members:
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?	I would be responsible for caring for the corgi.
Willing to train children?	I do not have children, but I am willing to teach any children that might come into my home how to treat animals respectfully and humanely.
Any allergies?	No one is allergic.
Current pets:
Current pets dog friendly?
Are you willing to work on it if your new dog doesn’t get along with your current pets right away?	Yes, I would be willing to try to resolve the problem if I would adopt any other pets in the future.
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: