Untitled_1768 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	04/15/2018	Referred by:	Other
Contact Information
First name:		Last name:		First name 2:		Last name 2:
Address
Street:
City:			State:		Zip:
Type of Dog Wanted
Ages interested in:	0 months – 1 year (we rarely get dogs in this age group)	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	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?	Me
Why do you want a Pembroke?	My daughter has a Corgi and I've dog sat her for several weeks. Great dog and very smart. Easy to train.
Activities planned with Pembroke:	Will train the Corgi. Should be bright and alert.
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:	Bring it to his/her attention and train him/her what the acceptable behavior. Change my tone of voice so they realize that I'm not pleased.
Discipline:	Change my tone of voice and train/encourage the correct behavior.
Where would Pembroke spend the majority of the time:	In the house with me.
Discipline:	Change my tone of voice and train/encourage the correct behavior. Where would Pembroke spend the majority of the time: In the house with me.
House dog or outside dog?	House dog
People at home during the day?	Yes, I work out of my home office.
Where would dog eat?	On the landing between the basement and first floor. That's where all my other dogs ate when I had them.
Where would dog sleep:	In my bedroom on a dog bed.
Play & exercise:	Daily walks several times a day. Inside play with toys.
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:	Grassy yard and 3 acres of woods and groomed trails.
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?	Des
Willing to train children?	Yes.
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?	I currently do not have any pets. My Cocker Spaniel was my last dog and I had to put him down about a year ago.
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: