Untitled_1893 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	06/24/2018	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, 3 years – 5 years, 5 years – 10 years	Gender preferred:	Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active
Other preferences:	Needs to be good with small children (4 and 7)
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 of 4.
Why do you want a Pembroke?	I do not have experience with the breed but have done research. I like that they are active, intelligent, easy to train and good with children.
Activities planned with Pembroke:	daily walks and playing in the yard
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:	Addressing it immediately but not using any physical means of discipline
Discipline:	by talking to the dog and a short time out
Where would Pembroke spend the majority of the time:	in our family room, not in a crate.
Discipline:	by talking to the dog and a short time out Where would Pembroke spend the majority of the time: in our family room, not in a crate.
House dog or outside dog?	House dog
People at home during the day?	not usually but I am a teacher and have long holiday and summer breaks.
Where would dog eat?	In out mud room
Where would dog sleep:	In our bedroom
Play & exercise:	With 2 busy kids we are naturally active and play outside often during all seasons.
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?	1 side is a solid 8 foot wood fence and the other sides are an a foot aluminum fence.
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:	small deck and patio
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?	Kim Mannel
Willing to train children?	Yes. We recently lost our dog and the kids were very caring with her.
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?	NA
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: