Untitled_1563 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	12/23/2017	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:	1 year – 3 years, 3 years – 5 years	Gender preferred:	Female	Color preferred:	Any color	Activity level:	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?	Diane
Why do you want a Pembroke?	I just put my 12 year old to sleep and he was the perfect dog. I want another one and he will have the very best home. My dog is my best friend and goes with me and lives with me in the house and sleeps in my bed and has his own bed in every room of the house. And I have a fenced playyard that is his. Toby walked the perimeter of his yard everyday until cancer was in his body. I miss him terribly and he has only been gone 2 days. He was smart and never ever had an accident in the house. He barked when anyone came in my yard and I loved that.
Activities planned with Pembroke:	Take him with me. Play retrieve each day because they love that. He explores outside when I am with him and he is out of his playyard. He goes with me in my tahoe and has his own poof cushion so he can see outside. He will get whatever he needs from me.
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:	verbal NO mostly my tone of voice is how I communicate with him
Discipline:	depends on what is happening. Like I said above, I use tone of voice, perhaps remove the dog from the situation….
Where would Pembroke spend the majority of the time:	in my home and with me when I go somewhere….
Discipline:	depends on what is happening. Like I said above, I use tone of voice, perhaps remove the dog from the situation…. Where would Pembroke spend the majority of the time: in my home and with me when I go somewhere….
House dog or outside dog?	House dog
People at home during the day?	yes me
Where would dog eat?	his food dish is in my bedroom along with his water dish….
Where would dog sleep:	In my bed or in his own bed but I prefer on my bed…
Play & exercise:	that is a daily event like it was with my Toby up until 2 days ago…he would bring me one of his toys and I would toss it and he would bring it back……every day…same thing with the ball in the outside playyard….
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?	4 foot high new fencing like they have in a school yard…..no way for him to get hurt at all…
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:	I live in the country and I raise American Quarter Horses. In fact, Terry Bradshaw, the football sportscaster, just bought a baby of mine and won the AQHA World with that baby. I know how to take care of animals. Have had a dog all of my life. My dog is my best friend, well….. I do have people friends but spend more time with my puppy. Take a look at my web site to see my place. I do not have pictures of the interior of my home for the world to see. www.dianemillerquarterhorses.com
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?	Diane M. Miller….ME
Willing to train children?	My child is 52 and lives in his own home and he is very good with his dogs too
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?	He will be the only pet in the house……
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: