Untitled_1485 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/03/2017	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	Gender preferred:	Female	Color preferred:	Any color	Activity level:	Outgoing
Other preferences:	Over the chewing stage, ok with being left alone during work hours every other day.
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?	Family
Why do you want a Pembroke?	I love that they are on the smaller side, also the fact that they are herding dogs. I have had two Australian cattle dogs so understand the high energy of herding dogs. I have done my research on the breed and have had interaction with the breed as well. They are adorable and very spunky. I love it!
Activities planned with Pembroke:	Walks twice a day, back yard play, Dog park play, doggie daycare from time to time, my work has one and also allows dogs in the Work place. Car travel
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:	It depends on the mistake. If there was an accident in the house I would redirect the dog outside. If the dog is begging for food I would say “No” sternly and point for the do to walk away.
Discipline:	Redirection or Stern voice
Where would Pembroke spend the majority of the time:	With me and my husband. Some alone time at home but the dog can go with me to work twice a week.
Discipline:	Redirection or Stern voice Where would Pembroke spend the majority of the time: With me and my husband. Some alone time at home but the dog can go with me to work twice a week.
House dog or outside dog?	House dog
People at home during the day?	No
Where would dog eat?	In the kitchen area
Where would dog sleep:	Dog bed or on my bed
Play & exercise:	Everyday exercise and play time
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?	Chain link fence around the whole yard
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:	It’s a sizable yard with a covered porch, shrubbery throughout the yard, garage, covered hot tub.
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?	Both of us
Willing to train children?	I do not have small children in the house.
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?	My cats have always been around dogs they have absolutely no problems. If our dog has a problem with the cats will work out a resolution.
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: