Untitled_1785 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	04/24/2018	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:	1 year – 3 years, 3 years – 5 years	Gender preferred:	Female	Color preferred:	Any color	Activity level:	Outgoing, Playful, Energetic, Very Active, Other (Please describe in the box below.)
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?	I currently have a Pembroke I adopted from LWCC 3 years ago and have now retired. Olivia (former name Lambeau) is now 6 years old. She would be a pet for me and a playmate for Olivia.
Why do you want a Pembroke?	I have adopted 3 Pembroke Welsh Corgis from the LPWCC. Corgis are very loving, gentle and devoted dogs. They are always good tempered and love people. There is a lot of activity in my home with the family in and out nearly every day.
Activities planned with Pembroke:	I would walk her with Olivia 7-10 miles per week, play ball and she would have many play toys.
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:	If I see it happening, I would gently speak and say no.
Discipline:	Verbal commands learned in obedience classes
Where would Pembroke spend the majority of the time:	Majority of the time would be with me because I would be home.
Discipline:	Verbal commands learned in obedience classes Where would Pembroke spend the majority of the time: Majority of the time would be with me because I would be home.
House dog or outside dog?	House dog
People at home during the day?	I would be home or another family member would be there
Where would dog eat?	In the kitchen
Where would dog sleep:	More than likely with me as does Olivia
Play & exercise:	She will be exercised every day and play time will be whenever she wants to play
How will you exercise your dog?	On leash
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?	It's both a wooden stockade (6 ft) and chain link (6 ft)
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:	The area where she would play has only trees and grass. No hot tub, swimming pool, etc
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?	Marie Van Gemert (self)
Willing to train children?	I have no small children. Grandchildren are adults who love corgis and often take Olivia home with them
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
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: