Untitled_2189 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	01/13/2019	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:	Red & White	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic
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?	Me, I have had three in the past, they have passed, and I would like another one.
Why do you want a Pembroke?	I love Corgis, they are short and with no tails, they do not knock things off the table.
Activities planned with Pembroke:	Training, playing, walking, socialization at the dog park.
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:	Positive reinforcement, I like using clickers and treats to train.
Discipline:	Ignore the wrong (so there is no response) and reward the good. Again, I like clicker training.
Where would Pembroke spend the majority of the time:	House
Discipline:	Ignore the wrong (so there is no response) and reward the good. Again, I like clicker training. Where would Pembroke spend the majority of the time: House
House dog or outside dog?	House dog
People at home during the day?	Yes, my husband works from home.
Where would dog eat?	Floor in the dining area.
Where would dog sleep:	Initially s/he will be crated but once s/he has shown us her positive behavior she will have the run of the house at night but her crate will always be available as her "safe spot".
Play & exercise:	Toys with a huge, fenced in backyard and daily walks.
How will you exercise your dog?	On leash
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?	Mostly chain link except for the "privacy gate" that leads to the driveway.
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:	About 1/3 acre surrounded by a chain link fence except in a small area where we have a privacy fence gate that leads to the driveway.
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?	Diana Judge
Willing to train children?	We do not have children but if children visit we will ensure they treat the dog well and vice versa.
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?	Absolutely. We will be sure to introduce the dog to the cats very slowly but since the cats were first, they will be alpha, unless all three of them identify a different alpha.
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: