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Applicant IL
State: {Applicant State:2} Date of Application: 08/05/2020 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
Gender preferred:
 Female
Color preferred:
 Any color
Activity level:
 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?

 Elena Levin

Why do you want a Pembroke?
 Elena has frequently played with and interacted with friend’s Pembroke Welsh Corgis. She loves the personality, playfulness, and energy of the breed as well as how sweet a corgi can be in interacting with her. She is very much a pupparazzi as she puts it. She is the person who will stop short and ask you politely for permission to interact with your dog even during COVID and then begin a love fest with your companion – fully masked of course while keeping an appropriate distance from you. She has done vast research on the breed as have we as her parents when she told us she wanted to replace the dog poodle she has cared for since she was 8 years old who recently died at age 15.5 years old and who she personally nursed in her apartment night and day as he suffered in his final year from congestive heart failure, a collapsing trachea, and advanced arthritis. She even bought him a doggy carriage And carried him up and down stairs every day so she could take him outside on walks to get to see people and other dogs as she ran her errands. The two of them went everywhere together her whole life, and they shared a bed every night.

Activities planned with Pembroke:
 Elena plans to take her corgi everywhere she did her toy poodle. She is legally entitled to an emotional support dog, and before COVID we live in a community in Saint Paul, MN, that is very dog friendly so she managed to take her poodle Mozart everywhere with her, even on public transit as well as shopping and to restaurants. She is a very active 24 year old and has always taken her dog running, walking, and when he couldn’t jump on the bed at our house, which is 10 blocks away from her apartment, she and I taught Mozart how to climb the puppy steps up to our king bed.
We also have a large, enclosed back yard. And just as Mozart was a member of our family, and new addition to Elena’s life would become our family member as well.

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: 		Firmly but gently. We plan to hire a private trainer familiar with corgis to work with Elena for several weeks to help her ensure the dog is potty trained in her environment, comfortable on a leash with her and able to handle commands. She trained her previous dog Mozart in a training class and on her own, but during COVID she wants the extra support of getting help individually.

Discipline:
 Gentle but firm encouragement and treats.

Where would Pembroke spend the majority of the time:
 In my daughter’s apartment and sometimes at our house

Discipline:
 Gentle but firm encouragement and treats.
Where would Pembroke spend the majority of the time: In my daughter’s apartment and sometimes at our house

House dog or outside dog?

 House dog

People at home during the day?
 Yes always

Where would dog eat?
 In my daughters apartment

Where would dog sleep:
 In Elena’s bed

Play & exercise:
 My daughter is a very active young woman who likes to her outside and walk and run with her dog.

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?
 It is both wood and metal and all possible places a small dog could creep through have long since been plugged up because our toy poodle was a runner!!

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:

 Yard has a deck that we can close off with a baby gate if needed.
My daughter has legal permission to have an emotional support dog in her rented apartment and has done So for the past three years with her landlords knowledge and approval

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?
 Elena Levin

Willing to train children?
 There are only adults. My daughter was raised to humanely care for all animals as well as human beings

Any allergies?

 One or more family members might be allergic to dogs.

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?
 There are no other pets

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}