Untitled_1764 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	04/13/2018	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:	Any age	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic
Other preferences:	Very open
Dog Ownership History
Previous dog owner?	No
	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?	For me and my son as well
Why do you want a Pembroke?	I have heard and researched that corgis have wonderful personalities.
Activities planned with Pembroke:	Walks. Playing catch. Taking him or her to pArents cabin and run for in a sizeable area in the country under a watchful eye.
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:	Voice control. These are smart dogs. Also check myself that I am providing proper guidance.
Discipline:	Voice control
Where would Pembroke spend the majority of the time:	With me as I work from home. Walks. Rides in car. With family as well as my two cats and brother's morkie
Discipline:	Voice control Where would Pembroke spend the majority of the time: With me as I work from home. Walks. Rides in car. With family as well as my two cats and brother's morkie
House dog or outside dog?	House dog
People at home during the day?	Yes in my home
Where would dog eat?	Kitchen.
Where would dog sleep:	In his or her bed or by me or my son.
Play & exercise:	I have 3/4 care for and many parks in the area.
How will you exercise your dog?	Both on leash and restrained to the yard
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:	I live on 3/4 acre lot with 2/3 open area
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?	Corri e Birrou
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?	I will aid with acclimating them
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: