Untitled_2111 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/21/2018	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
Other preferences:	Gets along with large dogs.
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 husband and myself.
Why do you want a Pembroke?	My current great dane, Riddick, has always been a companion dog. When our other dane, Odin, passed away, Riddick has been very sad and lonle since then. My daughter currently has a corgi. She lived at home when she got Forrest at 8 weeks old. When she moved out, she took Forrest with her. Riddick gets very happy when Forrest comes over to play.
Activities planned with Pembroke:	Take for walks and go to the dog park. Play in the yard.
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:	By telling them "no" and trying to show them the correct way and then give praise and positive reinforcement when they do.
Discipline:	Never physical discipline. Other methods depend on the action. I may take them out of an area or give them a time out.
Where would Pembroke spend the majority of the time:	At home with my Great Dane. My dad also lives with us and is home 5 days a week. During the warmer months, he spends time outside in the yard.
Discipline:	Never physical discipline. Other methods depend on the action. I may take them out of an area or give them a time out. Where would Pembroke spend the majority of the time: At home with my Great Dane. My dad also lives with us and is home 5 days a week. During the warmer months, he spends time outside in the yard.
House dog or outside dog?	House dog
People at home during the day?	Yes, my Dad is home 5 days a week and my 17 year old son gets home around 3PM from school.
Where would dog eat?	In the mud room off the kitchen.
Where would dog sleep:	Either in their crate or with our Great Dane.
Play & exercise:	My Great Dane is very active for his age. When we first got him at 8 weeks old, the breeder told us that his life expectancy was around 11 to 12 years. Any corgi will have ample play time with Riddick. We also love to take Riddick on walks. I usually walk about 1-1/2 to 2 miles at a time.
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 4 foot chain link fence on one side and along the rear and a 5 foot wood fence on the other side. There is a chain link gate on either side of the house. Our property is a half acre so the backyard is very large with plenty of room to run and play.
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:	My property is a half acre and the rear yard is very large. We have a deck and enclosed gazebo, along with a shed 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?	Julie Dziewior
Willing to train children?	My son has been around dogs since he was born and knows how to 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
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: