Untitled_1362 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	08/27/2017	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:	1 year – 3 years, 3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Red & White, Red Headed Tri, Sable & White	Activity level:	Playful, Energetic
Other preferences:	Please remember- just because I listed that I have a form of autism, I hope that doesn't lessen my chances of adopting a corgi. I have loads of love to give. I love animals more so than people, for the fact that you can count on them to be there when you need them.
Dog Ownership History
Previous dog owner?	No
	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 corgi would be for myself. I live alone in a two bed, two bath ranch in the country. I live right across from the Ripon Southwoods, which is a hiking trail. I live by myself, my two sons are grown, and I am 51. I would walk my corgi at least 2-3× a day, for 20-30 minutes or so. The corgis living quarters would be on the main floor, in my second living room area. I am receiving disability payments of $804 per month. I am actively looking for a job. My disability isn't physical, I have Ausbergers, a mild form of autism.
Why do you want a Pembroke?	My younger son's Dad had one, and it was the sweetest dog on the earth. I've been in love with them since. (Since about 2010)
Activities planned with Pembroke:	Walks, playing tug-of-war with chew toys, fetch, Chase me games, etc.
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:	Be firm, strong, but not overbearing.
Discipline:	Stern voice commands with steady eye gaze. Also, hand movements/motions for sit, stay, come,etc.
Where would Pembroke spend the majority of the time:	By me, wherever I am. Either in my house, or outside running and playing.
Discipline:	Stern voice commands with steady eye gaze. Also, hand movements/motions for sit, stay, come,etc. Where would Pembroke spend the majority of the time: By me, wherever I am. Either in my house, or outside running and playing.
House dog or outside dog?	House dog
People at home during the day?	Myself.
Where would dog eat?	Inside.
Where would dog sleep:	In my second living room. On her/his own blanket and pillow.
Play & exercise:	I will walk my corgi at least 2-3 times a day, for up to 30 minutes or more. My corgi will get constant, daily exercise.
How will you exercise your dog?	On leash
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?	Black wrought-iron heavy duty fencing with a gate that opens and shuts.
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:	Large, wooded tree lined yard on .60/acre. Country setting.
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?	Marie Zuber
Willing to train children?	My two sons are adults who don't have any kids.
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. My guinea pigs have their own bedroom.
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: