Untitled_1463 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	10/20/2017	Referred by:	Other
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	Gender preferred:	Either a Male or a Female	Color preferred:	Red & White	Activity level:	Playful
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?	Family We had a corgi for 14.5 years
Why do you want a Pembroke?	I loved my dog Laddie . His corgi swagger and his bark when my wife and I hugged.. I want to inter act with the family on daily walks going on vacations . Laddie still went on walks with us I a wagon , He could not walk long distances in his later years.
Activities planned with Pembroke:	Walking and interacting with the family.
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:	Talk to the dog. one snap of the leash and a command of heel.
Discipline:	Talk to the dog.
Where would Pembroke spend the majority of the time:	in the family home
Discipline:	Talk to the dog. Where would Pembroke spend the majority of the time: in the family home
House dog or outside dog?	House dog
People at home during the day?	No but I come home at lunch to let the dogs out.
Where would dog eat?	In the kitchen
Where would dog sleep:	In the bed room on dog beds
Play & exercise:	Daily walks play out side. my Laddie would love to tug on a rope.
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?	Plastic private fencing
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:	fenced in yard grass area is picket fenced. Pea gravel on side of garage for dogs. Trash can and shovel for pick up of dog waste
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?	Geoff Kowalczyk
Willing to train children?	Yes
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: