Untitled_2065 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	10/19/2018	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:	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, Energetic, Very Active
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?	Myself and family
Why do you want a Pembroke?	My brother and sister in law had a rescue. We fell in love with her. Since we owned a cabin she spent summers year after year with us when they came. When they would vacation we would take her so they didn’t have to board we. She became part of our family.
Activities planned with Pembroke:	We are a very active family. I walk daily and my husband and I ride as well. We have a nearby metro park we spend a lot of time at
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:	Take away toy or treat
Discipline:	Take away a reward
Where would Pembroke spend the majority of the time:	With us in our home or on our activities.
Discipline:	Take away a reward Where would Pembroke spend the majority of the time: With us in our home or on our activities.
House dog or outside dog?	House dog
People at home during the day?	Monday’s and Tuesday’s the house is empty from 730-200 Wednesday through Sunday there is typically someone always home
Where would dog eat?	In the kitchen
Where would dog sleep:	In a dog bed or crate. Our current dog has three beds in various rooms and prefers them to a crate.
Play & exercise:	I walk daily and we spend quite a bit of time at our local park
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:	We have a patio off our sliding door and grass beyond that and hour home backs up to a field which is separated by a tree line. Our subdivision restricts fencing in our neighborhood so our current dog has an extended leash that allows her to go all the way back to the yard just to the treeline but not beyond.
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?	Mary DeFalco
Willing to train children?	Yes they have had two dogs who have they have been around in our family since both kids were babies
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: