Untitled_2134 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	12/05/2018	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:	0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Quiet, Playful, Energetic
Other preferences:	Our dog will be walked daily, but we have a small unfenced yard, so a dog on the high end of the range would probably not be suited for us. On the other hand, our ultimate goal would be that our dog would be trained appropriately to be a true service dog and be able to accompany Cierra most anywhere where she goes, so the dog would need to be able to keep-up.
Dog Ownership History
Previous dog owner?	Yes
	Dog 1
	Dog 1 name:
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	Where is this dog now?
	Dog 2
	Dog 2 name:
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	Dog 3
	Dog 3 name:
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	Where is dog now?
	Dog 4
	Dog 4 name:
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Questions Regarding Motivation for Adopting and Intentions
Who is this dog for?	Cierra Campbell, age 13. I (Nancy) am Cierra's grandmother and guardian. Cierra has problems with depression and anxiety issues. We plan to work with a professional trainer on a weekly basis for 12-18 months so that Cierra's PWC will be able to serve as a service or support dog for her.
Why do you want a Pembroke?	Cierra and I have done a good deal of research about small dogs appropriate as psychiatric service dogs, and PWC are on most of the lists. Their activity level and ease-of-training fit our needs well. Their long lifespan is a plus. We are a bit concerned about grooming and shedding, but understand that daily grooming will be needed.
Activities planned with Pembroke:	We hope that our PWC will become a service dog for Cierra. We realize that at some point, we may need to make the decision to stop working with the dog on being a service dog and accept the dog as wonderful pet. Even if we don't reach our lofty goal, we think the breed would be a perfect companion and emotional support dog for Cierra. The same trainer that we will be working with also trains dogs to be therapy dogs. I'm a librarian; so I see a possible career for our PWC in the library field 🙂
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?	No
Vet contact info:
Will handle mistakes Pembroke makes like this:	I'm not expert- that's why we will be turning to a professional trainer for advice- but I'd assume firmly and promptly, looking to convey disapproval without anger.
Discipline:	I've not had a dog in many years. My last dog, Hank, was a well behaved I adopted through Mixed-up-Mutts. I don't really remember doing much in the way of training; I probably just got lucky. I have a husband and granddaughter living in home now, so I'm sure we will be much more deliberative in our training.
Where would Pembroke spend the majority of the time:	In our home. Ideally, he/she would be able trained enough to begin accompanying Cierra on outings to library, church, counseling appointments etc within first year. Eventually, accompanying her to school will be something we will need to discuss as we get closer.
Discipline:	I've not had a dog in many years. My last dog, Hank, was a well behaved I adopted through Mixed-up-Mutts. I don't really remember doing much in the way of training; I probably just got lucky. I have a husband and granddaughter living in home now, so I'm sure we will be much more deliberative in our training. Where would Pembroke spend the majority of the time: In our home. Ideally, he/she would be able trained enough to begin accompanying Cierra on outings to library, church, counseling appointments etc within first year. Eventually, accompanying her to school will be something we will need to discuss as we get closer.
House dog or outside dog?	House dog
People at home during the day?	I leave for work around 9am; Cierra and my husband are home by 3pm. I work just 5 minutes from home so would probably take lunch break around noon each day to let dog out mid-day.
Where would dog eat?	Most likely in the kitchen.
Where would dog sleep:	In Cierra's room, beside her bed. Cierra has trouble with sleep and lots of nightmares, so having her dog there where she can snuggle briefly then get back into bed seems ideal.
Play & exercise:	The daily walks will be necessary for dog and therapeutic for Cierra. Regular exercise is shown to be equally effective for depression as most anti-depressants. More extensive play/exercise will be weekly; we live within walking distance of a large park and a dog park.
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:	It is small and unfenced; maybe 200×50. There is a large graveled area in part of the yard that will likely be the "potty place." Fortunately, we live in a very walkable neighborhood.
Household members:
Everyone in household agrees about adopting a corgi?	No, some members of the family do not want 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?	Cierra Campbell
Willing to train children?	Yes. Cierra has always loved animals and they have always been in her life until she came to live with me 18 months ago. She will be going to training weekly with the dog and learning alongside him/her.
Any allergies?	No one is allergic.
Current pets:
Current pets dog friendly?
Are you willing to work on it if your new dog doesn’t get along with your current pets right away?	N/A we do not have any pets at this time.
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: