Untitled_2086 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/09/2018	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:	1 year – 3 years, 3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Outgoing, Playful, Energetic, Very Active
Other preferences:	like walking around the neighborhood. house and crate trained
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?	For myself and my wife
Why do you want a Pembroke?	We have a couple of neighbors who own PW Corgi. We have been researching the kind of dogs that fits to our life style. Corgi being loyal, energetic, like to be pet and close to the "parent". Clever and cute.
Activities planned with Pembroke:	Play in the backyard or dog park (throw and catch), walk around the neighborhood.
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?	No
Vet contact info:
Will handle mistakes Pembroke makes like this:	make a face, talk as if you are mad, dont pet or do brush immediately, and possibly put it a crate. take away the toy and stop playing for a while.
Discipline:	positive discipline: allow the dog to be awarded for good behavior and keep a distance for a while (like no brushing or petting) if the dog is not obedient.
Where would Pembroke spend the majority of the time:	indoor but not in the cage/crate.
Discipline:	positive discipline: allow the dog to be awarded for good behavior and keep a distance for a while (like no brushing or petting) if the dog is not obedient. Where would Pembroke spend the majority of the time: indoor but not in the cage/crate.
House dog or outside dog?	House dog
People at home during the day?	no, both my wife and i are still working (Mon-Fri); we are able to come home during lunch time so the dog will be by itself from 8-12 and 1-4.
Where would dog eat?	in the kitchen
Where would dog sleep:	either the dog's choice of area or with us in our bedroom.
Play & exercise:	we have a fenced backyard and we live in the neighborhood with walking trails and dog parks. We enjoy the outdoor a lot and we want to have the same oppotunity with the dog.
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?	metal fence with regular 3 feet in height. 2 exit doors that are securely closed all the time (one locked and one for gardener to enter the backyard)
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:	regular sized backyard with 2 apple trees. Only a movable bbq grill is placed in the backyard.
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?	Peter Pranadjaja (myself)
Willing to train children?	No more children living in our house. My youngest one has moved out of the house and an adult.
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?	No pet in the house.
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: