Untitled_1522 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/28/2017	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, Any age	Gender preferred:	Female	Color preferred:	Sable & White	Activity level:	Quiet
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?	Kaelyn
Why do you want a Pembroke?	I love the breed. I like their ears. I have done lots of research on how to care for a corgi and I think that a corgi is the best fit for our family
Activities planned with Pembroke:	We like to go for hikes, go to the dog park, go for long drives with the dog, if I adopted a corgi she would go everywhere with me and be getting certified as a therapy dog
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:	Firmly tell the dog that the mistake was unacceptable and put her in her crate for a time out period
Discipline:	We plan on using the kennel to teach the dog what is acceptable and what isn't
Where would Pembroke spend the majority of the time:	If we adopted a Pembroke she would spend her time with me working as an emotional support/therapy dog.
Discipline:	We plan on using the kennel to teach the dog what is acceptable and what isn't Where would Pembroke spend the majority of the time: If we adopted a Pembroke she would spend her time with me working as an emotional support/therapy dog.
House dog or outside dog?	House dog
People at home during the day?	Yes
Where would dog eat?	In the kitchen
Where would dog sleep:	In bed with me or in a dog bed in the bedroom
Play & exercise:	We go on daily walks and play fetch in the backyard
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 outside of the backyard
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 fenced in yard with a small wooden playground
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?	Kaelyn Isbell
Willing to train children?	Yes
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
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: