Untitled_1755 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	03/28/2018	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:	5 years – 10 years, 10 years +	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet
Other preferences:	We have thought long and hard about breed and the decision to adopt a dog.
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?	My family of 4 girls ages 4, 8, 11 and 13 would love to adopt an older corgi. We have a fenced yard. We are looking for a relaxed low energy dog that likes children, and would be OK at home alone most work days.
Why do you want a Pembroke?	We love that the breed is outgoing and playful, yet not super crazy like some breeds I’ve owned. We love the look of the short legs and ears.
Activities planned with Pembroke:	Walks, dog park 2 blocks away, play ball, play with kids in the house, chill out and watch TV
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:	If caught in the act, get attention and say “No” Try to anticipate when the behavior happens to be able to address it in the moment
Discipline:	Verbal cues, redirect, distract, dog-proof to prevent discipline issues
Where would Pembroke spend the majority of the time:	Being with us, except while we are working/school. Hopefully sleep with one of the girls.
Discipline:	Verbal cues, redirect, distract, dog-proof to prevent discipline issues Where would Pembroke spend the majority of the time: Being with us, except while we are working/school. Hopefully sleep with one of the girls.
House dog or outside dog?	House dog
People at home during the day?	Parts of days, me. But mostly we work
Where would dog eat?	Kitchen/mud room
Where would dog sleep:	Depends. At first maybe crate or wherever it feels comfortable. Hopefully in the room of one of the kids eventually.
Play & exercise:	We have fenced yard, and dog park 2blocks away. We’d have balls and toys and play inside too. We have a large house.
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?	We have a wood fence around our yard. It’s secure because we have a swimming pool.
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 yard with in-ground pool and separate area with grass
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?	Aimee
Willing to train children?	Yes. They have all owned pets before and have a good foundation.
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?	Yes definitely
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: