Untitled_2173 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	01/01/2019	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, 3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Red & White	Activity level:	Couch Potato, Outgoing, Quiet, Playful
Other preferences:	Good with children & cats
Dog Ownership History
Previous dog owner?	No
	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?	Family Wife, 5 year old son & 17 year old son
Why do you want a Pembroke?	Wife grew up with a Corgi & has been looking & waiting. We are ready to add a member to our family. I personally think they're cute & love the short stubby legs A neighbor a few houses down from us has two corgis & frequently brings them by for visits when out walking. My wife melts every time they come by & my kids both light up & can't get enough of their visits
Activities planned with Pembroke:	Play with & be a best friend to my 5 year old son. Play inside & outside, go for walks & car rides Be a full member of the family Cuddle
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:	The same way we deal with our cat & children take care of mistake, take corrective action based upon what happened & move on.
Discipline:	Similar methods we use on our cat & children. Tone of voice, time out, etc
Where would Pembroke spend the majority of the time:	Inside with us
Discipline:	Similar methods we use on our cat & children. Tone of voice, time out, etc Where would Pembroke spend the majority of the time: Inside with us
House dog or outside dog?	House dog
People at home during the day?	No. Just like most households in America, we are at work.
Where would dog eat?	Inside house. Have her own food & water dishes & location
Where would dog sleep:	Inside house. Would have her own bed but probably would sleep in bed with us
Play & exercise:	Lots of play & exercise with a 5 year old son in the house. Regular walks & family activity
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?	6' tall wooden fence in 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:	Fenced in back yard with a deck
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?	Beth & Bob – both of us
Willing to train children?	Yes. This has already been done since we have a cat
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, it is expected in the beginning
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: