Untitled_2097 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/13/2018	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:	Either a Male or a Female	Color preferred:	Red & White	Activity level:	Playful
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?	Family companion
Why do you want a Pembroke?	We adopted a Pembroke Welsh Corgi about 15 years ago, his name was Fritz and we adopted from the Iverson's who lived in Indianapolis at the time. We loved Fritz and he lived a full life of happiness. We are looking to replace Fritz who passed 5 years ago.
Activities planned with Pembroke:	large yard to play and long walks 1-2 miles 2-3 per day.
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:	Correct by motivating the corgi to do the correct thing. Treats or rewards.
Discipline:	Rewards and luring with rewards.
Where would Pembroke spend the majority of the time:	In the house
Discipline:	Rewards and luring with rewards. Where would Pembroke spend the majority of the time: In the house
House dog or outside dog?	House dog
People at home during the day?	Yes, home office
Where would dog eat?	Kitchen
Where would dog sleep:	Family room or living room
Play & exercise:	walked 2-3 times per day and access to large fenced in yard
How will you exercise your dog?	On leash
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?	6 foot fence on sides and 4 foot fence in rear.
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:	Above ground swimming pool 16 X32, fenced and locked gate to pool deck. Yard is 40 X 60, grass.
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?	Anthony Raia
Willing to train children?	No small children Daughter is 24
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 other pets.
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: