Untitled_2520

Applicant IL
State: {Applicant State:2} Date of Application: 08/05/2019 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:
 1 year – 3 years, 3 years – 5 years, 5 years – 10 years, 10 years +, Any age
Gender preferred:
 Either a Male or a Female
Color preferred:
 Red & White, Red Headed Tri
Activity level:
 Couch Potato, Playful, Other (Please describe in the box below.)

Other preferences:
 One who can be a little protective as I live alone. I had a 12 yr old Male. Just a luv!

Previous dog owner?
 Yes
 
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.

Why do you want a Pembroke?
 I had one previously. He was my Moms but she had to move. I had him for nearly 2 years. He was 12, so a little low key but spunky & stubborn. I loved him much! I love the personality (sassy & fun).He became I'll and passed recently.

Activities planned with Pembroke:
 Gardening. go for 30 minutes evening walks. Go for drives to nearby parks for walks & relaxing. Interact with toys they like.

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:
 {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: 		Depends on what type. Correct them gently and firmly and try again. Take a break if it becomes overwhelming etc…

Discipline:
 Firm but never force. Try to make it fun. Be persistant. Affection as positive reinforcement.

Where would Pembroke spend the majority of the time:
 My home with me. In the home when I am away or walking/gardening outside.

Discipline:
 Firm but never force. Try to make it fun. Be persistant. Affection as positive reinforcement.
Where would Pembroke spend the majority of the time: My home with me. In the home when I am away or walking/gardening outside.

House dog or outside dog?

 House dog

People at home during the day?
 Yes

Where would dog eat?
 In the kitchen mostly.

Where would dog sleep:
 My dog was allowed to sleep anywhere inside. Usually near my bed & a fan.

Play & exercise:
 I took my previous corgi for 30 minute walks daily. I tried toys but he didn't like them. I would try to play with him/her with toys and maybe go to the local dog park or general for a walk.

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?
 6 foot wood, 4' chain link & 1 small part 3' with barrier fencing added.

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?
 No

Description of yard:

 Basic yard. Front is unfenced. Garage is unattached and acts as part of fence. The backyard has a deck and 20×25 ' fenced area with garden areas. Very peaceful beighborhood.

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?
 Myself

Willing to train children?
 N/A

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?

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:
 {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}