Untitled_1579 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	01/03/2018	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, 3 years – 5 years	Gender preferred:	Male	Color preferred:	Red Headed Tri, Black Headed Tri	Activity level:	Outgoing, 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. I adopted a PWC 11 years ago. He was one year old at the time. Became a wonderful dog. He died last summer and I miss him very much.
Why do you want a Pembroke?	I recued a PWC 10 years ago. Love the personality, intelligence and playfulness of the breed. My Corgi accompanied me fishing and would swim in the streams. He was easily trained and became my constant companion, following me to the office when I did not have appointments.
Activities planned with Pembroke:	Walks, retrieving in my yard. fishing, hiking in the field.
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:	Scold with a low voice. I will train the dog to "leave it" and to sit and stay. I reward with affection when the dog behaves. I do not use physical punishment.
Discipline:	See previous answer.
Where would Pembroke spend the majority of the time:	At home, inside. He would also get plenty of exercise walking and playing in the yard.
Discipline:	See previous answer. Where would Pembroke spend the majority of the time: At home, inside. He would also get plenty of exercise walking and playing in the yard.
House dog or outside dog?	House dog
People at home during the day?	No, however I come home for lunch and I will take the dog to work fairly often.
Where would dog eat?	At home in the kitchen.
Where would dog sleep:	In my bedroom, Or, where he is most comfortable. He will have the run of the house.
Play & exercise:	He will have either a walk or retrieving in my yard or down a long hallway in my house, daily. The last Corgi I had maintained a consistent weight of 25 pounds and was healthy until the last year of his life when he had some health problems.
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:	I have a large backyard that while not fenced has structures and hedges that define it and tend to keep the dogs within the boundaries of my yard. That has been true for the three dogs I have owned. I live in a small town and there is little traffic even if the dog were to wonder. I also do not leave the dogs unattended or unsupervised when off the leash in the yard.
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?	Me.
Willing to train children?	My kids are grown. My neighbors have kids (and dogs) and I would be sure to get the dog and the kids familiar with each other.
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?	Not applicable. I have no other pet.
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: