Untitled_1612 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	01/25/2018	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, 3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Outgoing, Playful, Energetic
Other preferences:	Needs to get along with other dogs and cats
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?	Us
Why do you want a Pembroke?	We currently have a corgi mix and really enjoy her. We have fallen in love with the breed.
Activities planned with Pembroke:	We currently walk our corgi several times a week, take her on car rides, play in the yard. She loves to do tricks, we play fetch with balls and tug-of-war with a rope. She loves to wrestle and she loves to herd and groom the cat. Having another corgi as a companion for her would be wonderful for her. We would do all of these things with our new corgi as well.
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:	Tell her no making eye contact with her. Have her go to a preset place used only for discipline
Discipline:	See above.
Where would Pembroke spend the majority of the time:	In our house. Sleeping in one of the bedrooms
Discipline:	See above. Where would Pembroke spend the majority of the time: In our house. Sleeping in one of the bedrooms
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:	Bedroom with us
Play & exercise:	DaI'll playtime in house with one of us. Outdoors on walks around neighborhood or in the park down the street. Our teen daughters love to play fetch and tug-of-war with our current corgi.
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?	A short chain link with one gate in back yard.
Living arrangements:	Church parsonage
Landlord info:
May we contact your landlord?
Lease allow dogs:
Landlord permission:
Restrictive covenants?	Not applicable
Breed/size restrictions?	No
Description of yard:	Simple midsized chain link yard no pool.
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, Lillian, Kendra, John
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. Obedience training
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: