Untitled_2199 - Lakeshore Pembroke Welsh Corgi Rescue

Date & Referral Source
State:		Date of Application:	01/21/2019	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:	Female	Color preferred:	Any color	Activity level:	Couch Potato, Outgoing, Quiet, Playful, Energetic, Very Active
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?	Our family – we are a family of 5 plus we have a small rat terrier – 11 yrs old – named Zero – she loves all people and dogs
Why do you want a Pembroke?	We have never had this breed before but we just love their personalities – we think we could provide a good home for them. We have a friend who has a Corgi and loves her so much and we believe a Corgi could be a good match for us.
Activities planned with Pembroke:	We do everything with our dogs – walks, car rides, play in the backyard (we have a fenced back yard); go to the park, cuddle on the couch, play with toys, etc.
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:	Verbally scold and redirect – but we would do training with the dog
Discipline:	We mostly just calmly and firmly say no. And to be honest – we are terrible spoilers of our dogs.
Where would Pembroke spend the majority of the time:	In my our home – just go outside to play, go potty, walks, park , etc – but mostly in our home with us – our dogs are always right under foot. :o)
Discipline:	We mostly just calmly and firmly say no. And to be honest – we are terrible spoilers of our dogs. Where would Pembroke spend the majority of the time: In my our home – just go outside to play, go potty, walks, park , etc – but mostly in our home with us – our dogs are always right under foot. :o)
House dog or outside dog?	House dog
People at home during the day?	Yes. We are home all day every day except on Tuesdays – we are only away from home for 6-7 hours on Tuesdays.
Where would dog eat?	In our kitchen.
Where would dog sleep:	Well I must be honest – in my bed but we would but it a dog bed too. Mostly, our dogs sleep with one of us.
Play & exercise:	We love to play with the dog we have now and our dog that just passed away loved to play outside. We play indoors with toys and outside by running around.
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?	Large backyard with 5 ft tall fence
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:	Large backyard with a fence and a play ground equipment for kids. No swimming pools.
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?	Elizabeth Giromini
Willing to train children?	Yes
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: