Untitled_2046 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	10/02/2018	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, Very Active
Other preferences:	Should be ok with other dogs, as we may get another medium sized dog
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?	My family and me
Why do you want a Pembroke?	We want a smaller, working dog that can play fetch and interact with the family, but is also polite.
Activities planned with Pembroke:	Go out on walks, play ball, play with toys and belly rubs.
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:	If I catch it, I would stop the behavior or interrupt the dog and say, “no”. It’s important to get the dogs attention while catching him in the act.
Discipline:	Positive reinforcement with treats and praise for good behavior, spend a lot of time with the dog to catch any “bad” behavior and make him aware of what is acceptable and what isn’t. I have used a water spray bottle in the past to snap the dog out of aggressive behavior and it has worked, as well.
Where would Pembroke spend the majority of the time:	At home or out and about with me to run errands.
Discipline:	Positive reinforcement with treats and praise for good behavior, spend a lot of time with the dog to catch any “bad” behavior and make him aware of what is acceptable and what isn’t. I have used a water spray bottle in the past to snap the dog out of aggressive behavior and it has worked, as well. Where would Pembroke spend the majority of the time: At home or out and about with me to run errands.
House dog or outside dog?	House dog
People at home during the day?	Yes
Where would dog eat?	In the family room
Where would dog sleep:	Crate in bedroom
Play & exercise:	I’m usually home and active. I would take the Corgi out for walks with me daily.
How will you exercise your dog?	Both on leash and restrained to the yard
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:	No swimming pool. Large yard with birm that has large trees to block off the road. Approximately 1 acre of land.
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?	Peggy Troyer
Willing to train children?	Absolutely
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
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: