Untitled_1520

State: Date of Application: 11/28/2017 Referred by: Other
First name: Last name: First name 2: Last name 2:
Street:
City: State: Zip:

Ages interested in:
1 year – 3 years
Gender preferred:
Male, Either a Male or a Female
Color preferred:
Red & White, Red Headed Tri, Black Headed Tri, Sable & White, Any color
Activity level:
Outgoing, Playful, Energetic

Other preferences:

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?

Who is this dog for?

Family

Why do you want a Pembroke?
I love their precious faces and energy and loyalty.

Activities planned with Pembroke:
Ride to WI. Play in the yard wilts balls and toys.

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:
Depends on the mistake. Kindness is important.

Discipline:
Use kindness yet be firm


Where would Pembroke spend the majority of the time:
With the family

Discipline:
Use kindness yet be firm
Where would Pembroke spend the majority of the time: With the family

House dog or outside dog?

House dog

People at home during the day?
All day

Where would dog eat?
In the laundry room or kitchen

Where would dog sleep:
In our room

Play & exercise:
Every day multiple times a day in our yard with a family member

How will you exercise your dog?
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?
Partial fenced area. 3-4 ft high

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:

No pool. 5 acre farmers. Sheep, chickens.
We also have a 9 yr collie and a cat. Our previous corgi was totally bonded with both .

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?
Fred, Donna

Willing to train children?
We have a 3yr grandson who visits often who has always treated our animal gently and with love

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: