Untitled_2007 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	09/03/2018	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	Gender preferred:	Female	Color preferred:	Red & White, Red Headed Tri, Black Headed Tri, Any color	Activity level:	Outgoing, Playful, Energetic
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?	fpr myself
Why do you want a Pembroke?	I have owned one before and love how intelligent they are. Easy to train, fun to play with. All around one of the best dogs I have ever had.
Activities planned with Pembroke:	I love to go for walks so she would be walked every day, We live near a park and have a fenced in yard so we would play fetch. We would spend lots of time together.
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 a potty accident show her the accident tell her no and take her outside Chewing on something she is not supposed to tell her no take it away and give her something she is supposed to chew on.
Discipline:	Remove her from situations and put her where she is supposed to be or with what she is supposed to be with.
Where would Pembroke spend the majority of the time:	In the house with me and my family.
Discipline:	Remove her from situations and put her where she is supposed to be or with what she is supposed to be with. Where would Pembroke spend the majority of the time: In the house with me and my family.
House dog or outside dog?	House dog
People at home during the day?	Yes my mildly disabled son is home during the day.
Where would dog eat?	In the kitchen.
Where would dog sleep:	In my bedroom on the floor on her own bed on my side of the bed.
Play & exercise:	She will get a walk every day and would play in the backyard everyday.
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?	Wooden fence completely around the yard with spring hinges on the gates so they close automatically.
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:	Fenced yard with a shed. Nothing else but gardens.
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?	Jennifer Cochran
Willing to train children?	yes, my grandson lives with us and understands how to take care of and treat animals.
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 but all get along
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: