Untitled_1456 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	10/15/2017	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:	1 year – 3 years, 3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful
Other preferences:	Not an avid barking dog when left alone for periods of time.
Dog Ownership History
Previous dog owner?	No
	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?	Myself
Why do you want a Pembroke?	I am looking for a small dog that is not an avid barker but is very loving. One who will go on walks and play in a dog park but will also be content to sit in with me sometimes during the day and play inside.
Activities planned with Pembroke:	Obedience classes or other types of intelligence or agility training that the Pembroke is capable of. We would go to the dog park as often as possible for socialization and to burn excess energy.
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?	No
Vet contact info:
Will handle mistakes Pembroke makes like this:	Patiently, and with training, repeatedly teach the Pembroke the correct thing to do. Positive reinforcement of the correct behavior.
Discipline:	If the dog is doing something it shouldn’t, correct the dogs behavior by showing it that what it did was wrong and use positive reinforcement for the correct behavior. Never direct punishment.
Where would Pembroke spend the majority of the time:	With me out of a kennel unless I am away at work and no one can let it out to run.
Discipline:	If the dog is doing something it shouldn’t, correct the dogs behavior by showing it that what it did was wrong and use positive reinforcement for the correct behavior. Never direct punishment. Where would Pembroke spend the majority of the time: With me out of a kennel unless I am away at work and no one can let it out to run.
House dog or outside dog?	House dog
People at home during the day?	There is one other person home at night while I am at work.
Where would dog eat?	In the kitchen
Where would dog sleep:	Either in a kennel or with me
Play & exercise:	We will go to a fenced dog park whenever possible to run and burn off excess energy. We will also go on daily walks (30 minutes or so each) to get daily exercise.
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:	Rent/lease home
Landlord info:
May we contact your landlord?	Yes, you may contact my landlord.
Lease allow dogs:	Yes, my lease permits dogs.
Landlord permission:	Yes, my landlord is fine with me owning a Pembroke
Restrictive covenants?	Not applicable
Breed/size restrictions?	Yes
Description of yard:	There is a swimming pool outside of my apartment but it is gated.
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?	Myself
Willing to train children?	I have no children
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
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: