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Applicant IL
State: {Applicant State:2} Date of Application: 12/12/2019 Referred by: Website
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

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:
 Couch Potato, Playful, Energetic

Other preferences:

Previous dog owner?
 Yes
 
Dog 1
 
Dog 1 name:
 {Dog Name (Most recent/ current first):24}
 
Dog description:
 {Description of Dog:25}
 
How long owned?
 {Length of time owned:26}
 
Where is this dog now?
 {Where is this dog now? (Explain if you no longer have the dog):37}
  Dog 2
 
Dog 2 name:
 {Dog Name (Most recent/ current first):30}
 
Dog description:
 {Description of Dog:33}
 
How long owned?
 {Length of time owned:35}
 
Where is the dog now?
 {Where is this dog now? (Explain if you no longer have the dog):39}
  Dog 3
 
Dog 3 name:
 {Dog Name (Most recent/ current first):29}
 
Dog description:
 {Description of Dog:32}
 
How long owned?
 {Length of time owned:36}
 
Where is dog now?
 {Where is this dog now? (Explain if you no longer have the dog):27}
  Dog 4
 
Dog 4 name:
 {Dog Name (Most recent/ current first):28}
 
Dog description:
 {Description of Dog:31}
 
How long owned?
 {Length of time owned:34}
Where is this dog now? {Where is this dog now? (Explain if you no longer have the dog):38}

Who is this dog for?

 My family

Why do you want a Pembroke?
 I love corgis. I love how playful they are and how they are smaller (I am used to bigger dogs) I have a friend who owns a corgi and I love her corgi. Her corgi is super playful and loves going on walks and socializing. I also love how her corgi will cuddle. I know that corgis need to be brushed everyday, and obviously they need all the other normal dog stuff.

Activities planned with Pembroke:
 I could take it on walks in my pasture, I could also sit with it and watch movies. I like tug-a-war, but if it doesn’t want to do that I am up for some fetch or cuddles.

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:
 {If yes, please provide contact information including the vet’s name, clinic name, street address, city, state, zip, and phone. Also include the website if there is one.:52}

Will handle mistakes Pembroke makes like this: 		It really depends on what it did. I would probably scold it and tell it no, make sure it knows not to do it again.

Discipline:
 I tell my dog no or bad dog. Sometimes I put my dog in a room, by himself to punish him, but that is only when he does really bad things.

Where would Pembroke spend the majority of the time:
 In the house. Where ever, because I don’t kennel animals. When it wants to go outside I could let it out.

Discipline:
 I tell my dog no or bad dog. Sometimes I put my dog in a room, by himself to punish him, but that is only when he does really bad things.
Where would Pembroke spend the majority of the time: In the house. Where ever, because I don’t kennel animals. When it wants to go outside I could let it out.

House dog or outside dog?

 House dog

People at home during the day?
 There are people at my house except for a couple hours right in the middle of the day.

Where would dog eat?
 It would it eat in a room off of the entrance to the garage, just a few feet from the kitchen.

Where would dog sleep:
 It could sleep in the living room or in one of the three other rooms with dog beds.

Play & exercise:
 My corgi could go outside and play with my other dog(who is very good with other dogs). I could also play with it or any of my other family members. It could also wonder the yard if it wanted(I live on a farm so if it wants to wonder that is ok)

How will you exercise your dog?
 Restrained to the yard

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:
 {If you rent/lease your home, please list the name, telephone number and email address of your landlord. State “Not Applicable” if you own your own home.:67}

May we contact your landlord?

Lease allow dogs:

Landlord permission:

Restrictive covenants?
 Not applicable

Breed/size restrictions?
 No

Description of yard:

 I have no swimming pools, I have a big pasture and live far away kind of far from any public road, so there isn’t much of a risk of dogs getting hit by cars. There is really only grassy hills.

Household members:
 {Describe all the people who live in your home, include names, ages and interests. For example, Mary Smith, 29, Enjoys cooking, dog training, gardening and running.:75}

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?
 Sophie

Willing to train children?
 We don’t have any small children in the household, but if we did yes.

Any allergies?

 No one is allergic.

Current pets:

{Please list and describe all of the pets that currently live in your home, including the name, type, age, sex and whether it is neutered. For example, Lenny, komodo dragon, 3 years old, not neutered.:80}

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:
 {Personal References. Please list two people who know your family well, but who are not related to you (No moms, grandmas, sisters, etc) who will attest to the fact that you are a responsible, dedicated pet owner. Include the name of the person, their phone number(s), email and relationship you have with that person. For example, Mary Smith, 123-343-4444, 123-333-5767, marys@gmail.com, friend.:87}