State: {Applicant State:2} Date of Application: 07/12/2019 Referred by: Website
First name: {First Name:98} Last name: {Last Name:97} First name 2: {First Name 2:94} Last name 2: {Last Name 2:93}
Street: {Street Address:3}
City: {City:4} State: {State:5} Zip: {Zip:6}

Ages interested in:
0 months – 1 year (we rarely get dogs in this age group), 1 year – 3 years
Gender preferred:
Color preferred:
Red & White, Red Headed Tri, Sable & White
Activity level:
Couch Potato, Outgoing, Quiet, Playful

Other preferences:

Previous dog owner?
Dog 1
Dog 1 name:
{Dog Name (Most recent/ current first):24}
Dog description:
{Description of Dog:25}
How long owned?
{Length of time owned:26}
Where is this dog now?
{Where is this dog now? (Explain if you no longer have the dog):37}
  Dog 2
Dog 2 name:
{Dog Name (Most recent/ current first):30}
Dog description:
{Description of Dog:33}
How long owned?
{Length of time owned:35}
Where is the dog now?
{Where is this dog now? (Explain if you no longer have the dog):39}
  Dog 3
Dog 3 name:
{Dog Name (Most recent/ current first):29}
Dog description:
{Description of Dog:32}
How long owned?
{Length of time owned:36}
Where is dog now?
{Where is this dog now? (Explain if you no longer have the dog):27}
  Dog 4
Dog 4 name:
{Dog Name (Most recent/ current first):28}
Dog description:
{Description of Dog:31}
How long owned?
{Length of time owned:34}
Where is this dog now? {Where is this dog now? (Explain if you no longer have the dog):38}

Who is this dog for?

Myself and husband.

Why do you want a Pembroke?
My aunt has had corgis and we love how different their personalities vary. From playful to lazy and their different likes and dislikes. My husband has been obsessed with corgi videos and talks constantly about having another small dog to accompany dog peepers. We love that corgis are great family dogs, as we plan on starting a family later in the future.

Activities planned with Pembroke:
We love to go on walks in the park near our house, we go on road trips to visit family at the cabin, and we take our dog peepers to the beach often to swim. We enjoy incorporating our dog into any and all activities that we enjoy that they are able to tag along to. We also enjoy the occasional lazy day with movies and treats, and all of the snuggles.

Aware that Pembrokes are busy, noisy dogs?

Money for basic care?


Money for unforeseen medical expenses?

Willing to house train?
Willing to do formal training? Yes

Do you have a veterinarian?


Vet contact info:
{If yes, please provide contact information including the vet’s name, clinic name, street address, city, state, zip, and phone. Also include the website if there is one.:52}

Will handle mistakes Pembroke makes like this:
Address the problem with the dog, and redirect behavior with more training, or simple scolding. Depending on the severity of the situation seek outside obedience training.

Scolding with low tones, giving treats for good behavior.

Where would Pembroke spend the majority of the time:
Single family house with large yard and park nearby.

Scolding with low tones, giving treats for good behavior.
Where would Pembroke spend the majority of the time: Single family house with large yard and park nearby.

House dog or outside dog?

House dog

People at home during the day?
Occasionally. Husband works early hours and is home early afternoon, while I work late mornings to early evenings, so there would be a few hours of being home alone with another dog.

Where would dog eat?
In kitchen.

Where would dog sleep:
In our bed or in a dog bed in our bedroom.

Play & exercise:
We have a large yard and we have access to a large city park across the street.

How will you exercise your dog?
Both on leash and restrained to the yard

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:
{If you rent/lease your home, please list the name, telephone number and email address of your landlord. State “Not Applicable” if you own your own home.:67}

May we contact your landlord?

Lease allow dogs:

Landlord permission:

Restrictive covenants?
Not applicable

Breed/size restrictions?

Description of yard:

Simple backyard with one small tree.

Household members:
{Describe all the people who live in your home, include names, ages and interests. For example, Mary Smith, 29, Enjoys cooking, dog training, gardening and running.:75}

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?
Hannah Feltman

Willing to train children?
Yes, we do not have our own children but all of our friends and family have dogs and have taught their children safety around other animals. We plan on raising our future children around animals and to have respect for all living creatures.

Any allergies?

No one is allergic.

Current pets:

{Please list and describe all of the pets that currently live in your home, including the name, type, age, sex and whether it is neutered. For example, Lenny, komodo dragon, 3 years old, not neutered.:80}

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, we would like to be able to keep any corgi that is adopted forever and to not disrupt its placement. We would like to have both dogs go to obedience classes together if need be.

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:
{Personal References. Please list two people who know your family well, but who are not related to you (No moms, grandmas, sisters, etc) who will attest to the fact that you are a responsible, dedicated pet owner. Include the name of the person, their phone number(s), email and relationship you have with that person. For example, Mary Smith, 123-343-4444, 123-333-5767, marys@gmail.com, friend.:87}