Untitled_1637 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	02/07/2018	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:	Either a Male or a 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?	This pup would be a family pet. We have 3 children ages 14,15 and23
Why do you want a Pembroke?	We were first exposed to this breed because our friends own one. We instantly fell in love. We understand all Corgi's have different personalities. I have done a great deal of research on this breed and dream of owning one someday.
Activities planned with Pembroke:	We are an active family. Daily walks when weather permits. We also have our labradoodle in day care 3 days a week and would do the same for the corgi.
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 redirecting
Discipline:	redirecting or if absolutely necessary they would be kenneled
Where would Pembroke spend the majority of the time:	in the house with the exception of daycare days or going to my office.
Discipline:	redirecting or if absolutely necessary they would be kenneled Where would Pembroke spend the majority of the time: in the house with the exception of daycare days or going to my office.
House dog or outside dog?	House dog
People at home during the day?	Most days.
Where would dog eat?	At home in the kitchen area we have set up for the dog.
Where would dog sleep:	Where ever s/he chooses.
Play & exercise:	We will enroll him or her into local daycare 3x's a week and when not at daycare s/he would be walked or played with in our fenced in yard.
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?	We have a 5 foot fence around our whole yard.
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:	We have a large yard that is completely fenced in with a 5 foot fence.
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?	Marlena Niemeier
Willing to train children?	Yes, my children have always been around animals and they realize that this dog is family.
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?	Absolutely, again the trainer we use would be willing to help with any issues that may arise.
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: