Untitled_1515 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/26/2017	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, Any age	Gender preferred:	Female	Color preferred:	Red Headed Tri, Black Headed Tri, Sable & White	Activity level:	Playful, Energetic, Very Active
Other preferences:	Have always had 2 medium size canine companions. Because of a recent passing, only have one 13 year old female Australian Shepherd.
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?	Applicant
Why do you want a Pembroke?	My wife, who passed recently, had a Corgi as a young adult.
Activities planned with Pembroke:	Our dogs are have always been our children.. They are with me continuously. I ensure that they get the best food, supplements, veterinary care, and correct amount of exercise.for their age.
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:	positive reinforcement, Verbal repetition Physical repetition Reward correct behavior
Discipline:	Positive reinforcement Comfortable collar and lead Patience Ensure that the student enjoys any teaching experience and desires to please
Where would Pembroke spend the majority of the time:	At my side, with easy access to water and kennel
Discipline:	Positive reinforcement Comfortable collar and lead Patience Ensure that the student enjoys any teaching experience and desires to please Where would Pembroke spend the majority of the time: At my side, with easy access to water and kennel
House dog or outside dog?	House dog
People at home during the day?	Always. I am typically in my office or one of the public areas (kitchen, den, living rooms). If I must leave the house and weather or circumstances do not allow taking “the pups”, my Housekeeper is always in the home.
Where would dog eat?	I feed “the pups” twice daily. I prepare their food and am always in the same room.
Where would dog sleep:	In the same room, with a clean bed by my bed.
Play & exercise:	I maintain an active lifestyle. I will ensure that my new friend will receive adequate exercise. Too little may lead to weight gain and/or behavior problems. The right amount produces healthy rest and sleep.
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?	Our home is on 1/2 acre in a gated community. The back yard is surrounded by a 6’ masonry fence with metal gates, and includes a large pool and palm tree and fruit tree orchard. The kennel is on the side of the house is fully fenced with adequate shade. Dog doors allow 24 access. I check water and pickup the kennel daily.
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:	6,000 sq ft house is on 1/2 acre lot in a guard gated community. The back yard (1/4 acre) is surrounded by a 6’ masonry fence with a double metal gate, and includes a large pool, palm trees and a fruit orchard. Landscape and pool workers are allowed to enter the yard at designated times for maintenance. The kennel is on the side of the house and is separately gated. No one is allowed into the kennel. I change water and pick up the kennel daily.
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?	Robert Easterwood
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?	Cats are separately enclosed in a cattery.
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: