Untitled_2088 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/11/2018	Referred by:	Other
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	Gender preferred:	Male	Color preferred:	Red & White, Red Headed Tri, Black Headed Tri	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic
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 of 5!
Why do you want a Pembroke?	My sister in law has had their Pembroke Welsh Corgi for 6 years now. We enjoy visiting them and Buddy (their corgi) is always the first one to greet us and the last one to say goodbye! We have done loads of research online, as well as, discussed Buddy’s life in their home of 7. We love Corgis and want to add one to make us a family of 6!
Activities planned with Pembroke:	Walks on the trail, camping, fishing and traveling to see family in eastern Iowa.
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 him “No” and show no reward for actions
Discipline:	We will kennel the dog for a short period.
Where would Pembroke spend the majority of the time:	In the family living area and our bedroom.
Discipline:	We will kennel the dog for a short period. Where would Pembroke spend the majority of the time: In the family living area and our bedroom.
House dog or outside dog?	House dog
People at home during the day?	Yes
Where would dog eat?	In the kitchen
Where would dog sleep:	In a dog bed in the living area or our bedroom
Play & exercise:	We will take him on walks and to dog parks in the Des Moines area. Dog will be walked daily with play time with our family in the evenings after dinner time.
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:	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?	No, the condo covenants do not prevent me from having a dog.
Breed/size restrictions?	No
Description of yard:	Large field behind townhomes for him to roam and play.
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?	Chad Lane
Willing to train children?	Yes, our kids have grown up around animals.
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?	No current pets in home
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: