Untitled_1741 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	04/01/2018	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, 5 years – 10 years	Gender preferred:	Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful
Other preferences:	I also have cats & need them to get along.
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?	Myself
Why do you want a Pembroke?	We rescued a corgi once before and she was a wonderful dog. She liked being companionable with me and got along great with my adult kids and grandkids. She was sweet, smart, and funny. Other corgis I've met have been great personalities too. This is the breed for me and I really want to have another in my life.
Activities planned with Pembroke:	Couch surf, walks, occasional car rides and hanging out with family when they visit.
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:	Clean it up and pay closer attention to potty signals.
Discipline:	Verbal instruction such as "no" but otherwise is positive reinforxsmrnt.
Where would Pembroke spend the majority of the time:	In the house with me.
Discipline:	Verbal instruction such as "no" but otherwise is positive reinforxsmrnt. Where would Pembroke spend the majority of the time: In the house with me.
House dog or outside dog?	House dog
People at home during the day?	Yes. Me.
Where would dog eat?	In the kitchen unless other needs specific to the dog were given to me.
Where would dog sleep:	Anywhere it wants unless other needs.
Play & exercise:	Walks.
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:	Basic house and yard without pools or other special features.
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?	Myself, Doris. Lauren and Riley are getting an apartment and will not be living here. It will be my dog.
Willing to train children?	My grandson is already very good with animals and helps feed them.
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: