Untitled_2183 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	01/05/2019	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	Gender preferred:	Female	Color preferred:	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?	Me
Why do you want a Pembroke?	My little girl "pooches", a PWC with some mix, passed away at age 15+- a few months ago. I loved that dog.
Activities planned with Pembroke:	Walks ,hikes, travel
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:	Depends what the mistake is. Potty training requires patience and consistency Behavior issues require firm commands and consistency Good behavior is rewarded
Discipline:	See above
Where would Pembroke spend the majority of the time:	At home, on the trail in our front yard and wherever I go, usually
Discipline:	See above Where would Pembroke spend the majority of the time: At home, on the trail in our front yard and wherever I go, usually
House dog or outside dog?	House dog
People at home during the day?	Most of the day
Where would dog eat?	In the kitchen
Where would dog sleep:	In the bedroom
Play & exercise:	Already covered
How will you exercise your dog?	On leash
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:	Eisenbahn trail in my front yard, Milwaukee river just beyond, about 1/2 acre of back yard
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?	Me
Willing to train children?	Not an issue
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?	Not an issue
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: