Untitled_2093 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/12/2018	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:	Any age	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?	Myself
Why do you want a Pembroke?	I want to adopt a Pembroke Welsh corgi because I am a huge fan of herding dogs. I love their energy level, quirks, intelligence, and loyalty. I love corgis specifically because of their personalities (and of course the short legs help!)
Activities planned with Pembroke:	Hiking, jogging, walking, kayaking, camping
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:	I am a firm believer in positive reinforcement. All dogs make mistakes, as do people. If the corgi has behavioral problems, I am unable to alleviate with my training as a veterinary student, I would seek training guidance from someone with more experience than me in fixing the behavior.
Discipline:	I am a firm believer in positive reinforcement.
Where would Pembroke spend the majority of the time:	In the house or outside, depending on where I am at the moment.
Discipline:	I am a firm believer in positive reinforcement. Where would Pembroke spend the majority of the time: In the house or outside, depending on where I am at the moment.
House dog or outside dog?	House dog
People at home during the day?	Yes, as a student I often am home before 4pm and am able to come home on lunch breaks for potty breaks and play time.
Where would dog eat?	Royal Canin food, specific diet would depend on the corgi's needs
Where would dog sleep:	In my room, or on the couch… whichever it prefers
Play & exercise:	I live an active lifestyle outside of studying. I enjoy long walks, jogs, hikes and other outdoor activities. My current dogs join me in most of these activities. I do play with my dogs regularly (they love fetch!)
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?	Front yard – 3.5' picket fence Back yard – 8' wooden fence
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:	My yard is flat and completely fenced, there are no swimming pools or ponds present.
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?	Shahla Doroud (myself)
Willing to train children?	I do not have children.
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?	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: