Untitled_2823 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:	{Applicant State:2}	Date of Application:	02/15/2020	Referred by:	Friend, Breeder
Contact Information
First name:	{First Name:98}	Last name:	{Last Name:97}	First name 2:	{First Name 2:94}	Last name 2:	{Last Name 2:93}
Address
Street:	{Street Address:3}
City:	{City:4}		State:	{State:5}	Zip:	{Zip:6}
Type of Dog Wanted
Ages interested in:	3 years – 5 years, 5 years – 10 years, 10 years +	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic
Other preferences:	Prefer a dog that does not sit and bark just to bark.
Dog Ownership History
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}
Questions Regarding Motivation for Adopting and Intentions
Who is this dog for?	Myself.
Why do you want a Pembroke?	I'm a senior citizen and have had dogs all my life. I have been owned by 6 previous Corgis that needed a retirement home. My experience with the breed has been 'hands on'. I love the alertness and playfulness of the breed, as well as the dog's ability to be quiet and snooze near me and on my bed. My Corgis have been very adaptable and seemed to like people and other dogs.
Activities planned with Pembroke:	Take walks Play frisbee Go to a dog park Travels in the car Obedience class if desired
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:	Depends on the animal and the mistake Discontinue the action if that fits the situation Verbal commands Time out Positive reinforcement of the correct/desired action by the dog
Discipline:	Depends on the animal Discontinue negative action Verbal commands Positive reinforcement of the desired behaviour
Where would Pembroke spend the majority of the time:	With me In my house with me In my large fenced yard In my car with me
Discipline:	Depends on the animal Discontinue negative action Verbal commands Positive reinforcement of the desired behaviour Where would Pembroke spend the majority of the time: With me In my house with me In my large fenced yard In my car with me
House dog or outside dog?	House dog
People at home during the day?	Yes, I am home during the day.
Where would dog eat?	In a designated place in my kitchen
Where would dog sleep:	Hopefully, on my bed with me
Play & exercise:	I walk most every morning, and the leashed dog will go with me. We can play frisbee in my yard We can go to parks and dog parks
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 foot high white vinyl gated fence
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:	My yard is a little less than half an acre and is completely fenced with a 6 foot fence. There are a potting shed and a small fenced vegetable garden in my yard. My dogs and I spend lots of time on my large, open porch in pleasant weather.
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?	Carol
Willing to train children?	Children and grandchildren are all grown.
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?
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:	{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}