Untitled_1975 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	08/12/2018	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	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active
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?	Our family
Why do you want a Pembroke?	We have done research on the corgi and have been around corgis to know their loving and playful side.
Activities planned with Pembroke:	Walking and taking him with us on outings
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:	Say “no” and show him the correct action with a reward
Discipline:	Reward system
Where would Pembroke spend the majority of the time:	Inside the house
Discipline:	Reward system Where would Pembroke spend the majority of the time: Inside the house
House dog or outside dog?	House dog
People at home during the day?	No
Where would dog eat?	In his food bowl in the dining room
Where would dog sleep:	In his dog bed in the master bedroom
Play & exercise:	We live across from a park and can take him to get plenty of daily exercise.
How will you exercise your dog?	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?	Secure privacy fence
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:	Fenced in backyard on 1/4 of an acre.
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?	Elise
Willing to train children?	Yes
Any allergies?	One or more family members might be allergic to dogs.
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
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: