Untitled_2193 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	01/18/2019	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:	0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years, 3 years – 5 years	Gender preferred:	Either a Male or a Female	Color preferred:	Any color	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?	For us
Why do you want a Pembroke?	Our Ringo, who just recently died from lung cancer, was determined to be part Corgi. He was a stray that we rescued, so we cannot determine his full lineage, but he was clearly part corgi. He was such an integral part of our family, and I believe it is his corgi-like traits that made him such a goofy, endearing and loveable dog. He looked goofy, with his short legs, big ears and stout body, and acted goofy. He was loving and loveable and by no means sensitive or hard to manage. He was protective but loved everyone.
Activities planned with Pembroke:	Walks, chasing a ball, training for obedience, and whatever activities we find he enjoys. We have a fenced in back yard, perfect for chasing the many squirrels that visit.
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:	Look him in the eyes directly and tell him no.
Discipline:	Stern voice, direct eye contact, repeat as needed
Where would Pembroke spend the majority of the time:	At home, inside, outside as needed or desired. Our dogs sleep inside the home and are not kept outside as a rule.
Discipline:	Stern voice, direct eye contact, repeat as needed Where would Pembroke spend the majority of the time: At home, inside, outside as needed or desired. Our dogs sleep inside the home and are not kept outside as a rule.
House dog or outside dog?	House dog
People at home during the day?	Yes, my husband is retired, I work from home.
Where would dog eat?	He/she would have her own bowls in our guest bathroom, separate from our other dog who eats near the back door.
Where would dog sleep:	In our bedroom or the office, depending on his/her need for a crate.
Play & exercise:	At his/her will, they will be allowed outside. We play with them in the yard, and walk as the weather allows.
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?	Wooden privacy fence, approximately 7 feet tall on 3 sides, chain link on one side, approximately 4 feet tall.
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:	Grass, mulched beds with hostas, stone filler along the wall of the house. No pool, no yard toys or ornaments.
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?	Tracy
Willing to train children?	We do not have a child in the home, but often will have our granddaughter visiting. She is 9 months, not yet able to chase the dogs around. She is being exposed to dogs at home and at our home, and is being taught already to be gentle. She will be monitored while the dogs are present.
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: