Untitled_1916 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	07/07/2018	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:	1 year – 3 years, 3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful
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?	Me and my husband
Why do you want a Pembroke?	We have had the corgi breed for over 14 years, we just lost our beloved Tator to DM. I love the nature of the breed and they make the best friends a person could ever want in a pet!
Activities planned with Pembroke:	My boy that I rescued from Prairie Paws that we currently have gets 4 walks a day and lots of play time! We occasionally take hikes. Billy has the run of the house also. We have 5 acres. He is really depressed since our Tator went to the Rainbow bridge………………..
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 the mistake and move on
Discipline:	A firm no, and reward the correct behavior
Where would Pembroke spend the majority of the time:	House and yard with me. I leash walk my dogs
Discipline:	A firm no, and reward the correct behavior Where would Pembroke spend the majority of the time: House and yard with me. I leash walk my dogs
House dog or outside dog?	House dog
People at home during the day?	When not home I have a dog walker that I have used for years!
Where would dog eat?	In the kitchen
Where would dog sleep:	My bed with me or next to the bed in his own bed
Play & exercise:	4 walks a day, plus play time inside and out in enclosed yard with me
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?	Metal 4 foot tall
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:	Trees and grass and gardens
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?	Charlotta Serres
Willing to train children?	My daughter lives in Japan and is 27
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: