Untitled_1819 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	05/09/2018	Referred by:	Website, 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:	3 years – 5 years, 5 years – 10 years	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Outgoing, Playful
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?	Hollis and Katherine
Why do you want a Pembroke?	We have had a dog in our family since we married. Mostly we had Shelties, but 14 years ago we acquired a Pembroke Alpha Female who has been a delight. She died a month ago.
Activities planned with Pembroke:	We walk four times a day; we have a 9 pm neighborhood dog walking/snack/social group daily; we have dogs in our building and have a dog play/romp day monthly; dog accompanies us on outings when possible; we go to dog park once a week; dog has play hour(s) with friend/neighbor as arranged; do has 'work' in family routine inside and out.
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:	At the time; review expected response, repeat; reward.
Discipline:	Positive reinforcement; verbal clarity with dog about behavior lapse. Reinforce.
Where would Pembroke spend the majority of the time:	They would be with us in residence; outside four times a day for walks; with us on some outings.
Discipline:	Positive reinforcement; verbal clarity with dog about behavior lapse. Reinforce. Where would Pembroke spend the majority of the time: They would be with us in residence; outside four times a day for walks; with us on some outings.
House dog or outside dog?	House dog
People at home during the day?	Yes. we are retired and residential most of the day
Where would dog eat?	Food bowls in kitchen.
Where would dog sleep:	In bed on bath or in our bedroom in bed.
Play & exercise:	Four walks outside a day; play time in apartment with a toy am or pm. ''WORK" assistance with accompanying us on chores.
How will you exercise your dog?	On leash
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:	Rent/lease home
Landlord info:
May we contact your landlord?	Yes, you may contact my landlord.
Lease allow dogs:	Yes, my lease permits dogs.
Landlord permission:
Restrictive covenants?	No, the condo covenants do not prevent me from having a dog.
Breed/size restrictions?	Yes
Description of yard:	live in high rise apartment
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?	Hollis
Willing to train children?	Yes
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?	N/A
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: