Untitled_2218 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	02/03/2019	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:	Any age	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, 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?	This will be a family dog, but specifically an emotional support pet for Samantha, the mom and wife of the family.
Why do you want a Pembroke?	I am looking for a sweet dog to keep as my emotional support pet and the research I have done on Corgis is impressive! I really want one I can spoil and love!
Activities planned with Pembroke:	We would play if the dog is playful and go for walks outside. Otherwise we would cuddle on the couch and have fun inside!
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? No
Do you have a veterinarian?	No
Vet contact info:
Will handle mistakes Pembroke makes like this:	Correct the dog and always reward for doing something right!! Always loving and gentle!
Discipline:	Just the positive incentive system!!
Where would Pembroke spend the majority of the time:	In the apartment with Mommy!
Discipline:	Just the positive incentive system!! Where would Pembroke spend the majority of the time: In the apartment with Mommy!
House dog or outside dog?	House dog
People at home during the day?	Yes!
Where would dog eat?	In the house with us of course!
Where would dog sleep:	In their special bed or in bed with Mommy!
Play & exercise:	We go outside to play and for walks all the time!! We also have a nice yard outside of the apartment.
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:	Rent/lease home
Landlord info:
May we contact your landlord?	Yes, you may contact my landlord.
Lease allow dogs:	Yes, my lease permits dogs.
Landlord permission:	Yes, my landlord is fine with me owning a Pembroke
Restrictive covenants?	Not applicable
Breed/size restrictions?	No
Description of yard:	NA
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?	Samantha
Willing to train children?	Yes
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?	NA
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: