Untitled_1904 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	06/30/2018	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:	0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years	Gender preferred:	Either a Male or a 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?	Myself, I have gotten 3 rescues from LPWCC. My last rescue Morgan died a month and a half ago.
Why do you want a Pembroke?	I love the breed! I’ve had 4 Corgis. The first from a breeder and the last 3 from rescue.
Activities planned with Pembroke:	Walks and playing. I took all my Corgis to training classes.
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:	Correct, praise, reward
Discipline:	Raised voice and hand signals. My last rescue Morgan, was deaf for the last 7 years of her life and I found hand signals are great.
Where would Pembroke spend the majority of the time:	I work from home so she would be with me all the time and get long and short walks.
Discipline:	Raised voice and hand signals. My last rescue Morgan, was deaf for the last 7 years of her life and I found hand signals are great. Where would Pembroke spend the majority of the time: I work from home so she would be with me all the time and get long and short walks.
House dog or outside dog?	House dog
People at home during the day?	I am home all day, as noted I work from home.
Where would dog eat?	The dining room.
Where would dog sleep:	In my bedroom. All my past Corgis slept on my bed and the had another bed on the floor.
Play & exercise:	Lots of walks, 2 long ones each day and 2 shorter ones each day.
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:	Rent/lease home
Landlord info:
May we contact your landlord?	Yes, you may contact my landlord.
Lease allow dogs:	Yes, my lease permits dogs.
Landlord permission:	Yes, my landlord is fine with me owning a Pembroke
Restrictive covenants?	Not applicable
Breed/size restrictions?	No
Description of yard:	None
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?	It’s only myself, there are no others who live with me.
Willing to train children?	Not applicable
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?	Not applicable
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: