Untitled_1629 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	02/02/2018	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, Either a Male or a Female	Color preferred:	Any color	Activity level:	Outgoing, Playful, Energetic
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 dog. 15 year old daughter loves this breed and would like a younger dog who would enjoy agility.
Why do you want a Pembroke?	We have really enjoyed our Aussie- love the herding dog mentality. We like family oriented dogs!
Activities planned with Pembroke:	Agility training, hiking, frisbee, hiking, camping
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:	Give firm verbal commands. Redirection Distraction Positive reinforcement
Discipline:	“No” said firmly Ignore negative behavior to avoid reinforcing Consistency.
Where would Pembroke spend the majority of the time:	With his/her family At least initially we would use a crate when he/she is left alone in the house or take to a doggie day care during work hours if needed.
Discipline:	“No” said firmly Ignore negative behavior to avoid reinforcing Consistency. Where would Pembroke spend the majority of the time: With his/her family At least initially we would use a crate when he/she is left alone in the house or take to a doggie day care during work hours if needed.
House dog or outside dog?	House dog
People at home during the day?	We are nurses with different shifts. There would be 2 days a week in which he/she would be at the house without humans for 8 hours.
Where would dog eat?	In the kitchen
Where would dog sleep:	In our bedroom on a dog bed
Play & exercise:	We live next door to a huge park with hiking trails and big body of water. Our Aussie goes out in the kayaks with us. We use dog life jackets.
How will you exercise your dog?	On leash
Fenced yard?	No, I don’t have a fenced in yard.
Willing to pick up dog waste?	Yes, I will clean up after my dog.
Willing to use a crate?
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 fence. .36 acres, wooded backyard sunny lawn in front. No water around home. I busy street in front.
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?	Bella
Willing to train children?	Yes
Any allergies?	No one is allergic.
Current pets:
Current pets dog friendly?	No, some of our current pets are not 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, our dog was initially aggressive with cats, we trained/socialized him with them until all was well. They are now best friends
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: