Untitled_2002 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	09/01/2018	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, Energetic
Other preferences:
Dog Ownership History
Previous dog owner?	No
	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?	For us
Why do you want a Pembroke?	We think a corgi would be a wonderful addition to our family. A close family friend has a corgi which we spend time with regularly- we like his general demeanor and personality, as well as his playfulness and energy
Activities planned with Pembroke:	Walks, playing in fenced backyard, lounging on the couch, play dates with other dogs, traveling in car, visiting family and friends
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:	Immediately acknowledge the mistake so he/she knows what the discipline is for
Discipline:	Verbal
Where would Pembroke spend the majority of the time:	Inside the house
Discipline:	Verbal 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?	Our dog would not be left alone for more than 5 hours per day
Where would dog eat?	In the pantry/ mud room
Where would dog sleep:	In our bed, or on his/her bed. Whatever is most comfortable for him/her
Play & exercise:	Twice daily walks, playing in large fenced backyard, playing in large finished basement, play dates with other dogs
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?
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:	Large fenced yard. Fire pit is only fixture.
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?	Jordan and James
Willing to train children?	We do not have children, nor do we plan to have children. We have nieces and nephews who live in homes with many dogs/cats/guinea pigs/birds/reptiles. We spend a lot of time with them and from our observation treat all animals with kindness and respect. We will explain the rules and expected behavior of any human in our home with respect to our dog and cat.
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?	Absolutely
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: