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Applicant IL
State: {Applicant State:2} Date of Application: 02/01/2020 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:
 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:

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?
 The breed is adorable. I had a Corgi in the past. She was sweet, rarely stubborn, loved children, loved to play fetch for hours, she chased cats and rabbits out of our yard but never went after the in house cats. We had no fences and she never went past the trees that bordered the yard, somehow she just knew what was ours. I was able to train her to walk well on a lead, her kennel was open in the house, she spent time in it when she wanted to be there. Others that knew the bread said she was irregular with her attitude. Loved swimming as well. I never taught her, she just jumped in one day to fetch a ball that went too far. Loved being groomed. When someone would knock on the door, she would bark once like a doorbell and sit quiet waiting to see who was there. I loved how she would go from room to room making sure all the people where there when visiting my parents on holidays and then come sit back down by me without direction. I used to take her to regular vet/chiropractic visits to help keep her back in good shape. She loved her visits with them.

Activities planned with Pembroke:
 Walking, Fetch, car rides from Green Bay to Chicago, she slept on the bed when she wanted, visited with friends who had children. Lots of cuddling.

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: 		I would walk up to her, firmly say no, let her see my disappointment, take her outside or away from what it is she was doing.

Discipline:
 I never locked her in the kennel. That was her safe place. Time outs in the rest room if needed. Firm words or phrases usually distract from the activity. Bad Dog when needed, good dog when deserved. Squirt bottle if necessary.

Where would Pembroke spend the majority of the time:
 Roaming free in the house with me. Mystic laid in her open Kennel if she did not want to be on the couch with me. She was kennel trained when I received her. I was told it was her home within our home. She loved to be in it with her stuffed animal babies.

Discipline:
 I never locked her in the kennel. That was her safe place. Time outs in the rest room if needed. Firm words or phrases usually distract from the activity. Bad Dog when needed, good dog when deserved. Squirt bottle if necessary.
Where would Pembroke spend the majority of the time: Roaming free in the house with me. Mystic laid in her open Kennel if she did not want to be on the couch with me. She was kennel trained when I received her. I was told it was her home within our home. She loved to be in it with her stuffed animal babies.

House dog or outside dog?

 House dog

People at home during the day?
 I live alone. Sometimes she would be alone, other times I work from home.

Where would dog eat?
 In the kitchen.

Where would dog sleep:
 Where ever she felt safe. Bed, Kennel, floor.

Play & exercise:
 When I had Mystic, we would walk every morning, then at lunch time and again at night. After the evening walk, I would play fetch with her. How long depended on the day and weather. She did not like the rain. She swam in her kiddie pool in the summer and I cut paths in the snow in the winter. She loved to play fetch. On rainy days I would toss her toy a few times in the house only. She tended to stop and pee if we did more than that in the house. For which she was not punished as I felt it was my own fault.

How will you exercise your dog?
 On leash

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?
 Yes

Description of yard:

 I live in a trailer home/park. We have no fences, dogs are not permitted to be left alone outside and must be on a leash and picked up after. I happen to live across the street from the park where I can take her to run. I also live within one mile of the neighborhood dog park. I have friends that I visit that have land and children. There is a pond at one friends house where she could swim only when supervised.

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?
 Nathalie

Willing to train children?
 I have one friend with children that come into my home. They have 3 dogs at their own home. They know to be gentle with the dogs they have 2 are shitzus and the other a larger mixed breed.

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}