Untitled_1546 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	12/09/2017	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)	Gender preferred:	Either a Male or a Female	Color preferred:	Red & White, Sable & White	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active
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?	Me, family pet
Why do you want a Pembroke?	I have never owned one but have been “friends” with some at the dog park. They are such clowns and so sweet. I like that they are smart and the perfect size for my life.
Activities planned with Pembroke:	Dog park, regular long walks. We are a very active family. I’d like to do agility training, though I’ve never done it before.
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 upon the mistake. Never hit,
Discipline:	Treats
Where would Pembroke spend the majority of the time:	Free range of the house. My domestic partner and I have opposite schedules so some one is almost always home.
Discipline:	Treats Where would Pembroke spend the majority of the time: Free range of the house. My domestic partner and I have opposite schedules so some one is almost always home.
House dog or outside dog?	House dog
People at home during the day?	Yes, see above. He works nights, I work days.
Where would dog eat?	Kitchen
Where would dog sleep:	It’s own bed in our bedroom
Play & exercise:	Lots of dog park. 1/4 acre yard to play in. Lake neighborhood to swim in and run on in the winter. We are very active and fit and love walking around the neighborhood after dinner and after dropping kids on the bus. I would like to do agility as well.
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:	1/4 acre yard, 1 block from the lake. No fence but we have thought about putting one in. Suburban neighborhood
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?	Marky Sutherland, Adam Funk
Willing to train children?	Yes. My girls have grown up with 2 dogs at their fathers 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?	Na
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: