Untitled_1423 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	09/29/2017	Referred by:	Breeder
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	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active
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?	My Family.
Why do you want a Pembroke?	I love the size of the dog with the big dog personality.
Activities planned with Pembroke:	We live in the country so a lot of outside time, plus we go camping in the summer months. If I had a little more time I would love to do agility.
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:	It depends on the mistake. If its a accident in the house its usually the humans fault. If it's a dominate issue, I will turn them on there back and hold them there till they are quiet.
Discipline:	Once again it depends on whats going on. Examples mentioned above.
Where would Pembroke spend the majority of the time:	At home, if we are not at home either loose in the house or kenneled (whatever they are more comfortable with). My current corgi has some anxiety so she prefers to be kenneled. Some days they come to work with me. Depends on the season and how busy we are.
Discipline:	Once again it depends on whats going on. Examples mentioned above. Where would Pembroke spend the majority of the time: At home, if we are not at home either loose in the house or kenneled (whatever they are more comfortable with). My current corgi has some anxiety so she prefers to be kenneled. Some days they come to work with me. Depends on the season and how busy we are.
House dog or outside dog?	House dog
People at home during the day?	Each day is different. If school is in, and work schedules very each week. Like I mentioned in the previous box, sometimes they come to work with me.
Where would dog eat?	In the kitchen from a dog dish.
Where would dog sleep:	Any where they want. Couch, bed (if they don't jump off in the middle of the night because we don't want them to hurt their backs). Kennel if that makes them comfortable.
Play & exercise:	toys, balls, outside or inside
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:	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:	We live on 4 acres, with 1 acre of yard. No pool or anything. Chicken coop and horse pasture near by.
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?	Terri Heise-Sturm
Willing to train children?	Yes, we have many animals and they are very respectful.
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: