Untitled_2119 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/27/2018	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:	Energetic
Other preferences:	We have a male Blk Headed Tri 2 years old that likes to take walks would like to have another
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?	Laura&Sara…mother&daughter
Why do you want a Pembroke?	Yes we gave a 2year old corgi now just love our furrrr nugget
Activities planned with Pembroke:	Maverick is 2years old he loves his walks 2-3 times a day just loves his outting!! He like going to the beach,if we go to the pool he jumps in too!!
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:	Verbal VERY firm tone
Discipline:	Verbal
Where would Pembroke spend the majority of the time:	Inside home or on 1of our outings
Discipline:	Verbal Where would Pembroke spend the majority of the time: Inside home or on 1of our outings
House dog or outside dog?	House dog
People at home during the day?	Yes
Where would dog eat?	Dishes are located in kitchen
Where would dog sleep:	Maverick our 2 year old corgi likes to sleep in Laura's bed…or in kitchen on linoleum floor think cause it's cool on summer nights..and Maverick sleep in living room on his back..lol…
Play & exercise:	Dailey 2-3 times a day….between 30 mins to 1 1/2 hrs depending on weather&items!
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/inside trailer park
Landlord info:
May we contact your landlord?
Lease allow dogs:
Landlord permission:
Restrictive covenants?	Not applicable
Breed/size restrictions?	Yes
Description of yard:	Very end lot so big yard
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?	Laura Ball&Sara Ball
Willing to train children?	Yes…all my children are adults…when I get Grandchildren they will learn how to care for our furrr friends!
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 of course
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: