Untitled_1405 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	09/18/2017	Referred by:	Friend
Contact Information
First name:		Last name:		First name 2:		Last name 2:
Address
Street:
City:			State:		Zip:
Type of Dog Wanted
Ages interested in:	3 years – 5 years, 5 years – 10 years	Gender preferred:	Female	Color preferred:	Red & White	Activity level:	Outgoing
Other preferences:
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?	Us
Why do you want a Pembroke?	I grew up with welsh corgis and love their intelligence, their almost permanent smile,
Activities planned with Pembroke:	We will go on long walks and play ball.
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:	Remove her from the situation and place her in her crate.
Discipline:	Putting her in her crate.
Where would Pembroke spend the majority of the time:	Where ever we are.
Discipline:	Putting her in her crate. Where would Pembroke spend the majority of the time: Where ever we are.
House dog or outside dog?	House dog
People at home during the day?	Most of the time. I work part time and my husband works from home doing tele-psychiatry.
Where would dog eat?	Recommended dog food.
Where would dog sleep:	In a basket in our room.
Play & exercise:	She will be taken on daily walks and plying ball in a park.
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?
Living arrangements:	Own home
Landlord info:
May we contact your landlord?
Lease allow dogs:
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 and have no yard.
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?	We both will take care of the dog.
Willing to train children?	Yes. We don't have children any more. Grandchildren may come to visit.
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?	We have no other pets.
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: