Untitled_1470 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	10/26/2017	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, 3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, 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?	Myself
Why do you want a Pembroke?	My previous dog, Ori, was a Corgi/Border Collie mix and was the best dog ever. She was smart, affectionate, and protective of her people. I adopted her in 2006 from a shelter. She was diagnosed with lymphoma in March 2017 and I immediately initiated chemo. She had 6 rounds of chemo from March-July and was in total remission. On August 1, however, she had a syncopal episode. After an EKG and pericardiocentesis, the vet advised she was a "ticking time bomb." She began to exhibit all the signs of right-sided heart failure (bloated appearance, difficulty breathing, incontinence) soon after. I called Lap of Love on August 16, 2017 and she passed peacefully at home at 13 years old. I've been heartbroken since and would like another dog of similar breeding as a companion.
Activities planned with Pembroke:	Daily walks, playing catch/fetch, visits to dog park (assuming she/he gets along with other dogs)
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:	Usually the mistakes a Corgi makes are not intentional (such as eliminating in the house). I would determine what the factors were that caused him/her to have the issue and correct it. If training was necessary, I would contact PetSmart for Obedience courses.
Discipline:	With my previous dog, I never had to discipline because she KNEW when she did something wrong. As mentioned above, they usually don't act out intentionally. However, if there was aggression or destructive behavior, I would contact a dog trainer to remedy the situation.
Where would Pembroke spend the majority of the time:	When we are not home, he/she would be crated IF they are already crate-trained. Otherwise, they would have free-roam of the house. My previous dog was not crate-trained and had free-roam of the indoors.
Discipline:	With my previous dog, I never had to discipline because she KNEW when she did something wrong. As mentioned above, they usually don't act out intentionally. However, if there was aggression or destructive behavior, I would contact a dog trainer to remedy the situation. Where would Pembroke spend the majority of the time: When we are not home, he/she would be crated IF they are already crate-trained. Otherwise, they would have free-roam of the house. My previous dog was not crate-trained and had free-roam of the indoors.
House dog or outside dog?	House dog
People at home during the day?	Yes. My roommate works from home.
Where would dog eat?	My previous dog was fed Science Diet Lamb and Rice. I would feed a similar diet to a new dog.
Where would dog sleep:	In the bedroom with me. He/she would have their own bed or be able to sleep in my bed. I have "stairs" that they would be able to use to climb into bed.
Play & exercise:	Daily, at least 1-2 hours
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?	approximately 4 ft tall; white PVC fencing. Yard is about 1/4 acre.
Living arrangements:	Rent/lease home
Landlord info:
May we contact your landlord?	Yes, you may contact my landlord.
Lease allow dogs:	Yes, my lease permits dogs.
Landlord permission:	Yes, my landlord is fine with me owning a Pembroke
Restrictive covenants?	Not applicable
Breed/size restrictions?	No
Description of yard:	I currently rent from my roommate who owns the house. The front yard is not fenced, but the back yard is. There are no obstructions in the yard and it backs up to a pond.
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?	Myself
Willing to train children?	Yes, The children live with us part-time and were familiar with my previous dog. They also have dogs at their mother's home.
Any allergies?	No one is allergic.
Current pets:
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?	There are no plans to add additional animals however if that occurred, the dog would be a priority. If issues could not resolve themselves, the dog would stay and the new animal would be re-homed.
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: