Untitled_1336 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	08/12/2017	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, 5 years – 10 years	Gender preferred:	Either a Male or a Female	Color preferred:	Red & White, Red Headed Tri, Sable & White	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?	Husband, wife, and two older children who visit frequently and are available for dog sitting.
Why do you want a Pembroke?	We currently have a pemproke welsh corgi that we got as a puppy and is now 10. He is a member of the family and the sweetest cutest dog ever. We would like another to learn from Sparky before he is gone.
Activities planned with Pembroke:	Frequent walks, attempt to play fetch (which usually ends up as tug of war and catch me if you can)
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:	firmly speaking to him at a time when it is clear what we are talking about.
Discipline:	He has never been hit or abused.
Where would Pembroke spend the majority of the time:	Inside our home.
Discipline:	He has never been hit or abused. Where would Pembroke spend the majority of the time: Inside our home.
House dog or outside dog?	House dog
People at home during the day?	Most of the time but our current dog does spend up to 6 hours alone at times.
Where would dog eat?	My wife has researched this extensively and our dog only gets the best dog food and treats.
Where would dog sleep:	In his own dog bed in our bedroom.
Play & exercise:	Several walks a week and playing inside the house and yard.
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?	Invisible fence. Our current dog has never left the yard.
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:	1/4 acre suburban lot. 2 story house with finished basement. Lots of stairs.
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?	No, I will not 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?	Paul & Jane
Willing to train children?	Not applicable, but maybe some grandchildren someday.
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
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: