Untitled_1950 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	07/31/2018	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, 5 years – 10 years	Gender preferred:	Either a Male or a Female	Color preferred:	Red & White, 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?	The dog is for family. We have a 12 yr old Pembroke that we adopted from you in 2009. She's getting old and needs a companion.
Why do you want a Pembroke?	We have a pembroke. We love their playful, smiley spirit and size. Easy to train and good temperment. Unfortunately, she is pretty blind and deaf now so less playful. She is too attached to one family member so that is frustrating.
Activities planned with Pembroke:	Lots of walks. Ball tossing. Some agility work is fun. We did that with our current dog a few times when she was younger and she was very good.
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:	Tell it no if we catch it in the act. Change the situation so it is less likely to happen again (move the item to a safer place if it destroyed something) or put the dog in a separate place so it can't happen again.
Discipline:	verbal commands for positive and negative. treats for rewards
Where would Pembroke spend the majority of the time:	at home… When we are at work, she may be isolated in an area or crate if not house trained. It might come to work with me. I own a business.
Discipline:	verbal commands for positive and negative. treats for rewards Where would Pembroke spend the majority of the time: at home… When we are at work, she may be isolated in an area or crate if not house trained. It might come to work with me. I own a business.
House dog or outside dog?	House dog
People at home during the day?	Somewhat…. But not consistently. I can take a pet to work since I own a business. It really depends on the dog and its needs.
Where would dog eat?	in our dining room where our current corgi eats.
Where would dog sleep:	on the floor in our bedroom. possibly in a crate until it knows our house and we're confident it makes it thru the night.
Play & exercise:	we take walks twice a day with our current corgi
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:	Corner house with side yard. No backyard.
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?	Sam Essak
Willing to train children?	yes but our kids are older. we explain how to approach a dog to young kids on the street when we walk.
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?	Our corgi is not real interested in other animals but I think she will like more companionship as she ages.
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: