Untitled_1415 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	09/26/2017	Referred by:	Website
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:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic
Other preferences:	Need a dog that gets along with other dogs and people, enjoys loafing as well as walks, dog park, and lots of love
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?	Me and my family. My adult children visit often and I have two tenants in my home that are dog lovers and often assist with my 3 labs and beagle. Beagle was a foster fail:).
Why do you want a Pembroke?	I find the breed to be endearing in behavior and appearance. I love that they are quite smart, playful, active and smaller as I have usually had larger dogs. My experience with friends dogs are that they are funny, protective, playful and so intelligent.
Activities planned with Pembroke:	Dog walks, ( I take them on a 3 mile walk through a park) dog park, playing in the yard and cuddling at night
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:	Clean it up take dog outside.
Discipline:	Firm voice, possible crate briefly.
Where would Pembroke spend the majority of the time:	In the house free to roam lower level- kitchen- living room – bathroom. Frequent time outside on long lead.
Discipline:	Firm voice, possible crate briefly. Where would Pembroke spend the majority of the time: In the house free to roam lower level- kitchen- living room – bathroom. Frequent time outside on long lead.
House dog or outside dog?	House dog
People at home during the day?	Yes
Where would dog eat?	In the kitchen. All dogs have their own bowl and area.
Where would dog sleep:	In the living room with the pack:)
Play & exercise:	Daily time outside and on walks.
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?	Not applicable
Breed/size restrictions?	No
Description of yard:	Large yard with long tie outs for dogs to walk and do business. I do daily " scoops" to avoid walking through it. I have a deck and a patio.
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?	Cindy
Willing to train children?	No small children
Any allergies?	No one is allergic.
Current pets:
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 have fostered several dogs and they have gotten along ( beagle just stayed- foster fail)
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: