Untitled_2121 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	11/29/2018	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:	3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Sable & White, Any color	Activity level:	Couch Potato, Outgoing, 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?	My husband and I
Why do you want a Pembroke?	I have several friends who have corgis and have told me what wonderful companions they are. I have a rescued corgi mix that’s a total sweetheart.
Activities planned with Pembroke:	We like to take walks and car rides and of course lots of snuggles.
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:	With patience and understanding
Discipline:	I just say no in a firm voice
Where would Pembroke spend the majority of the time:	In our house
Discipline:	I just say no in a firm voice Where would Pembroke spend the majority of the time: In our house
House dog or outside dog?	House dog
People at home during the day?	Part time
Where would dog eat?	We use pure life dog food, lamb and rice
Where would dog sleep:	With us or in a dog bed
Play & exercise:	We take daily walks
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?	Not applicable
Breed/size restrictions?	No
Description of yard:	We live on 1 acre in the country, have an above ground pool
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?	Stormy
Willing to train children?	We have no 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: