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State: Date of Application: 07/08/2018 Referred by: Website
First name: Last name: First name 2: Last name 2:
Street:
City: State: Zip:

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:

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?

Who is this dog for?

Myself

Why do you want a Pembroke?
Previous Rottweiler owner. My condo and age restrict that breed. I would like a smaller but similar character.

Activities planned with Pembroke:
I walk daily. We have local dog parks. I have worked with my dogs on agility. My friends and family all have dogs. I’ll need to assess the individual dog to understand her activity preferences.

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?

No

Vet contact info:

Will handle mistakes Pembroke makes like this:
Dogs need to be shown how you want them to behave. Our direction should be clear and consistent.

Discipline:
Redirection. Positive reinforcements for the corrected behavior. Consistent, loving directions.


Where would Pembroke spend the majority of the time:
With me. I work from home. I take my dogs with me when I go where they are welcome. I’ll crate train a dog at first until I can leave them safely in my condo alone.

Discipline:
Redirection. Positive reinforcements for the corrected behavior. Consistent, loving directions.
Where would Pembroke spend the majority of the time: With me. I work from home. I take my dogs with me when I go where they are welcome. I’ll crate train a dog at first until I can leave them safely in my condo alone.

House dog or outside dog?

House dog

People at home during the day?
I am

Where would dog eat?
In our home

Where would dog sleep:
In my bed room

Play & exercise:
Multiple walks per day. Other dog play times several times per week: family, friends, dog parks.

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?
No, the condo covenants do not prevent me from having a dog.

Breed/size restrictions?
Yes

Description of yard:

I live in a condo. The association restricts “bully breeds”. There are no hazards such as pools. There are no private fenced areas. We will need to go to a dog park for free running.

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?
Myself

Willing to train children?
Yes for any child visiting. No child lives in my condo with me.

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?
Yes. I would carefully introduce any animals that will interact with my dog companion.
I won’t adopt another pet with out prior believe they can happily coexist.

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: