Untitled_1521 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/28/2017	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:	0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years	Gender preferred:	Male	Color preferred:	Any color	Activity level:	Outgoing, Quiet, Playful, Energetic, Very Active
Other preferences:
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?	My 16 year old son
Why do you want a Pembroke?	I have researched the breed and they seem to be very social, active and good natured dogs. Plus, I like the size of the breed.
Activities planned with Pembroke:	Take it on daily walks. Play fetch out in the yard. Sit on the couch in the evening together.
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:	Teach it that it shouldn’t have chewed something up.
Discipline:	Not sure
Where would Pembroke spend the majority of the time:	With us, unless we are not home then in a crate. Once the dog is trained and we know that we can trust him. then he will not have to go into the crate.
Discipline:	Not sure Where would Pembroke spend the majority of the time: With us, unless we are not home then in a crate. Once the dog is trained and we know that we can trust him. then he will not have to go into the crate.
House dog or outside dog?	House dog
People at home during the day?	Yes, 4 to 5 days a week
Where would dog eat?	In the kitchen
Where would dog sleep:	Probably in bed with my son
Play & exercise:	There will be daily walks and play time
How will you exercise your dog?	Both on leash and restrained to the yard
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:	Open yard no fence
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?	Heather Calby
Willing to train children?	Yes
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: