State: {Applicant State:2} Date of Application: 01/12/2020 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
Gender preferred:
Either a Male or a Female
Color preferred:
Any color
Activity level:
Couch Potato, Playful, Other (Please describe in the box below.)

Other preferences:
must be good with kids
must be good with other dogs
likes car rides
and enjoys being spoiled to some degree

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?

looking for a companion for myself. My family is loving. i have a husband and a total of 4 kids, ages are 11, 10, 9, and 7. We currently have a german shepard named Niko who is 9 and has always been around other animals and is good with them. Can be on the go but want someone that wants to go with me on daily adventures including to work. i work for an insurance company answering phones out of my own private office. we want to expand the love that we have with another dog that we can call the newest member of our family.

Why do you want a Pembroke?
have been doing my research and from what i have read i know they bark quite a bit and i am fine with that. besides being adorable i like their size and the fact that they are known to be good with kids and more relaxed than other small breeds.

Activities planned with Pembroke:
travel, which includes trips to my moms house on an old farm
walks cause i love to hike and walks around the neighborhood
the park the place the kids love to go
the beach which arent in small supply here in door county
the drive in movie theater which is a family favorite during summer time

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:
depends on what is considered a mistake. from my experience with dogs usually what would be considered a mistake is simply them being bored and needing more attention. for me it would mean to make more time than what was and create more activity. longer walks more busy body toys or something to that sort.

walks and exercise have always been the best. discipline for a dog is not that same in my book.

Where would Pembroke spend the majority of the time:
with me. at home doing lord knows what and going to work with me on a regular basis

walks and exercise have always been the best. discipline for a dog is not that same in my book.
Where would Pembroke spend the majority of the time: with me. at home doing lord knows what and going to work with me on a regular basis

House dog or outside dog?

House dog

People at home during the day?
not currently

Where would dog eat?
in the kitchen have a doggie station set up that niko currently occupies but is big enough for multiple little furry babies.

Where would dog sleep:
they could sleep in which ever bed they choose to sleep. whether it would be mine or one of the 4 kids beds.

Play & exercise:
there is always an opportunity with the kids if i have stuff to get done, with niko who needs a small companion, and walks with me on a regular basis

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?
we have an invisible dog fence buried in the yard. the collars make noise when they get close and vibrate as they get closer. if they go over it sends a shock. dont like the shocking part but has worked wonders with our sheppard. he doesnt even wear the collar anymore yet still wont go near where the fence is.

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:

our yard is a nice size. we are surrounded by farm fields with plenty of trees that surround the property. we dont have a pool. the house has an attached garage. we have just over an acre of property

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?
crystal manson

Willing to train children?
yes. all the kids have been around animals since they were born so have learned as they have grown.

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?

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}