Untitled_2110 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/20/2018	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, 5 years – 10 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:
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?	This is for me.
Why do you want a Pembroke?	I love the breed. I think they are beautiful and are s loyal dog.
Activities planned with Pembroke:	I would take walks, and play with him. Most of all I eould give this fog lots of lo e.
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 would not scold him but would resesrch what training was required to trsin him,
Discipline:	I will tell them no or just reward good behavior.
Where would Pembroke spend the majority of the time:	Most of the time would be in my condominium.
Discipline:	I will tell them no or just reward good behavior. Where would Pembroke spend the majority of the time: Most of the time would be in my condominium.
House dog or outside dog?	House dog
People at home during the day?	My Dad is at home.
Where would dog eat?	He would eat in my kitchen.
Where would dog sleep:	He would likely sleep with me or in his own bed.
Play & exercise:	He would play in the park with me and my other dog Grigsby.
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:	Own home
Landlord info:
May we contact your landlord?
Lease allow dogs:
Landlord permission:
Restrictive covenants?	No, the condo covenants do not prevent me from having a dog.
Breed/size restrictions?	No
Description of yard:	I do not live in a house. I live in a condo.
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?	Me
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: