Thank you for your interest in Mayflower PWCC Corgi Rescue.  Please complete this form as completely as possible.  There are no wrong answers! We are trying to get a snapshot into what sort of dog might best fit your lifestyle and home.  Answers with a RED ASTERISK require an answer. 
 
If you cannot answer, please type NA into that particular box.

APPLICANT INFORMATION

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ADULT(S) IN YOUR HOUSEHOLD * 
 NAME & AGEOCCUPATIONHOBBIES/ACTIVITIES
YOU
OTHER
OTHER
CHILDREN IN YOUR HOUSEHOLD 
 NAMEAGEACTIVITIES
NAME
NAME
NAME
NAME

CHARACTERISTICS DESIRED IN A PWC

DESIRED PEMBROKE CHARACTERISTICS *
SEX/COLOR
WOULD YOU CONSIDER MORE THAN ONE DOG? *
WOULD YOU CONSIDER A DOG WITH MANAGEABLE HEALTH ISSUES? *
WOULD YOU CONSIDER A DOG THAT REQUIRES BEHAVIORAL TRAINING? (separation anxiety, fear aggression, etc)? *
CHOOSE THE TOP 5 ATTRIBUTES IN ORDER OF IMPORTANCE, 5 IS MOST IMPORTANT 1 IS LEAST:

LIVING SITUATION

DESCRIBE THE TYPE OF HOME SITUATION YOU LIVE IN 
 
NEIGHBORHOOD SETTING
DO YOU OWN OR RENT? *
IS THERE A FENCED YARD *
0/500 characters

ANIMAL EXPERIENCE

ARE THERE DOGS NEXT DOOR/NEARBY? * 
 
ARE ANY HOUSEHOLD MEMBERS ALLERGIC? *
WILL SOMEONE BE HOME DURING THE DAY *
DO YOU PLAN TO ENROLL IN A TRAINING CLASS? *
HAVE YOU TRAINED A DOG PREVIOUSLY? * 
 
EVEN WITH THE BEST OF TRAINING AND CARE, A DOG MAY REVERT IN ITS BEHAVIOR AND TRAINING WHEN PLACED IN A NEW AND STRANGE SITUATION. THEY MAY LOSE THEIR HOUSETRAINING, MAY BECOME FEARFUL, MAY BECOME SHY OR DESTRUCTIVE. WOULD YOU BE ABLE AND WILLING TO PROVIDE PROPER TRAINING IN SUCH SITUATIONS AND SEEK ASSISTANCE *

EXISTING PETS

DO YOU HAVE ANY OTHER PETS AT THIS TIME? *
OTHER PETS IN HOME (EVEN PART TIME!) 
 PET 1PET 2PET 3PET 4
SPECIES (dog/cat/bird/reptile/rodent)
BREED
PERSONALITY
AGE
SEX (m/f)
NEUTERED (y/n)
VACCINATED (y/n)
HAVE YOU OWNED A DOG BEFORE? * 
 
HAVE YOU EVER ADOPTED FROM A RESCUE/SHELTER BEFORE? 
 

REFERENCES

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