Untitled_1871 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	06/12/2018	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:	0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years	Gender preferred:	Female	Color preferred:	Any color	Activity level:	Couch Potato, 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?	Us. We had two Corgies for about 13 years. One was a rescue one was from a breeder. We lost them 6 months a part a little over a year ago. One to a brain tumor and the other had cancer when he was two and had diabetes for the last 4 years of his life. He started having seizures and the Dr thought she cancer came back and went to his brain. I was physically sick for a month after losing our second. We loved them and gave them the best care possible.
Why do you want a Pembroke?	We love Corgies and love the personalities they have. Big dog in a small body.
Activities planned with Pembroke:	We have a huge fenced in yard with lots of trees squirrels and birds. We have taken our Corgies on vacations with us to Tenn. We have a great park near with great walking trails that our Corgies loved.
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 reinforcement
Discipline:	Positive reinforcement. Very treat oriented.
Where would Pembroke spend the majority of the time:	At home with Phil ( Me ) I work 15 hours a week.
Discipline:	Positive reinforcement. Very treat oriented. Where would Pembroke spend the majority of the time: At home with Phil ( Me ) I work 15 hours a week.
House dog or outside dog?	House dog
People at home during the day?	I work 15 hours max per week so I'm home most if the time.
Where would dog eat?	We have a designated space in our kitchen ( a closet has been converted into the fog room. The door is removed and food and water are elevated.
Where would dog sleep:	In the bed room
Play & exercise:	Doggie day care, with us waking and playing in our 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?	Chain link 175 x 100 foot area all grass and trees.
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:	175 x 100 ft grass and trees. Chain link all the way around.
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?	Phil
Willing to train children?	Zero kids in our house. Youngest nephew is 16
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?	Yes
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: