Untitled_1878 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	06/15/2018	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:	We have a Corgi mix, Obi Wan, Age 6. We had a Pembroke purebred rescue from Age 4 until Age 17. We miss you, Merlin!
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?	Our family. Paul, 52, Jen 51, daughter Claudia, 22.
Why do you want a Pembroke?	We love PWC's smiles, friendliness, ease with people and other dogs, curiosity, playfulness, smiles, lovingness, loyalty, , smiles.
Activities planned with Pembroke:	Playing, walking, building snow loaves, learning, herding ducks (we are frequently visited by ducks on our pond.)
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:	Say No. Explain the mistake.
Discipline:	We use positive reinforcement to train and timeouts to correct.
Where would Pembroke spend the majority of the time:	In the house, except for walks and playtime outside.
Discipline:	We use positive reinforcement to train and timeouts to correct. Where would Pembroke spend the majority of the time: In the house, except for walks and playtime outside.
House dog or outside dog?	House dog
People at home during the day?	During weekdays, we are all out from 10:30 am until 4 pm.
Where would dog eat?	In the dining/breakfast room.
Where would dog sleep:	At night, in a crate. During the day, we have several dog beds throughout our home.
Play & exercise:	Daily walks for exercise. Daily play time outside and inside.
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:	About 3000 square feet, with a pond bordering. 12 trees. Flower beds on edges.
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?	Paul
Willing to train children?	Yes. No minor children here.
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: