Untitled_1772 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	04/17/2018	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:	Any age	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	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?	me
Why do you want a Pembroke?	yes
Activities planned with Pembroke:	yes
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:	fix
Discipline:	fix
Where would Pembroke spend the majority of the time:	yes
Discipline:	fix Where would Pembroke spend the majority of the time: yes
House dog or outside dog?	House dog
People at home during the day?	s
Where would dog eat?	s
Where would dog sleep:	s
Play & exercise:	s
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?	No, I will not 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?	Yes, the condo covenants do prevent me from owning a dog.
Breed/size restrictions?	No
Description of yard:	d
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?	n
Willing to train children?	n
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?	n
Lifetime commitment to Pembroke?	No, I am not willing to commit to this dog for the rest of its life.
Return to Lakeshore if unable to care for Pembroke?	No, I am not willing to agree to surrender my adopted corgi to LPWCR if I am unable to care for it.
Understand no guarantees?	No.
Carefully considered the pluses and minuses of adopting a pet?	No, I haven’t really given this much thought at all.
Personal references: