Untitled_2158 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	12/24/2018	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, 5 years – 10 years, 10 years +	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing
Other preferences:
Dog Ownership History
Previous dog owner?	No
	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 of 4 consisting of 2 teens and 2 adults
Why do you want a Pembroke?	When I was a kid we owned one briefly. The size is ideal for our home. And they are affectionate and happy dogs with minimal grooming needs.
Activities planned with Pembroke:	Daily walks! I’m a walker. Car rides. Playing in our yard. Socializing with my parents’ golden and brittany and with my brother’s collie.
Aware that Pembrokes are busy, noisy dogs?	Yes
Money for basic care?	Yes
Money for unforeseen medical expenses?	No
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:	What constitutes as a mistake? It takes time for a dog to acclimate and learn it’s new home. If it’s the potty, I would never blame the dog for that because we would have a schedule of taking it out and learn it’s patterns and body language.
Discipline:	Redirecting. And lots of positive reinforcement.
Where would Pembroke spend the majority of the time:	Indoors
Discipline:	Redirecting. And lots of positive reinforcement. Where would Pembroke spend the majority of the time: Indoors
House dog or outside dog?	House dog
People at home during the day?	Yes, my oldest child. He’s homeschooled.
Where would dog eat?	In the kitchen by our fridge.
Where would dog sleep:	In one of my children’s bedrooms. Either in his own bed or with them.
Play & exercise:	I will take it for a walk right after school and after dinner. On the weekends we will go to our forest preserve, weather permitting. When going in our backyard for potty there will be playing with it’s preferred toy. Ball? Tug? The backyard is lit up at night so it’s not pitch black.
How will you exercise your dog?	Both on leash and restrained to the yard
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?	Chain link 4 feet with 3 gates.
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:	No pools. Just a chain link back yard. There’s a small fire pit in the middle of the backyard.
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?	Kimberlee
Willing to train children?	Yes
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?	NA
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: