Mini-Application Supplemental Information

MINI-ADOPTION APPLICATION SUPPLEMENTAL INFO

Applicant(s)

Address

City

Zip Code

Phone Number

Email (required)

Name of Dog

APPLICANT REFERENCES (Provide names and phone numbers and/or email addresses of people we can contact)

*Please note restrictions below:

1. Please let the references know that a SCR representative will be contacting them
2. Please do not list family members as a reference
3. Please make sure that the vet reference you provide is a vet you have used personally or, if you are establishing a new relationship with a clinic, please make both us and the clinic aware of this. The vet reference SHOULD NOT be one a family member has used or uses, if it is not one that you personally use.

********** 1st Reference **********

Name

Relationship

Phone Number

Email (required)

********** 2nd Reference **********

Name

Relationship

Phone Number

Email (required)

********** 3rd Reference **********

Name

Relationship

Phone Number

Email (required)

If you have dogs currently or have owned them recently, please provide contact information for the veterinary facility where they receive or did receive their routine care.

Veterinarian Reference

Phone Number

Email (required)

Thank you for your interest in offering a home to a rescued Pembroke Welsh Corgi! We try to match our rescued dogs with their new families for the best chance of success. The following questions are to help us decide which dog will fit your family and lifestyle best.

HOUSEHOLD INFORMATION

How many people live in your home?

Are there any children living in or that regularly visit your home?
—Please choose an option—NoYes

If yes, Please list ages

Do you currently have pets in your home?
—Please choose an option—NoYes

Please tell us about dogs you have owned previously.

Do you live in a:
—Please choose an option—Single family homeApartmentDuplexManufactured Home

Do you:
—Please choose an option—Own your homeRent your home

Do you have stairs in your home?
—Please choose an option—NoYes

Do you have a pool?
—Please choose an option—NoYes

Is there a fenced in area for dogs on your property?
—Please choose an option—NoYes

Is your home in a high traffic area?
—Please choose an option—NoYes

DOG INFORMATION

Are you willing to take your new dog to obedience classes?
—Please choose an option—NoYes

What activities are you interested in doing with your new dog?
Dog Sports (Agility, Obedience, Rally, etc.)RunningWalkingOther
If Other, Please Explain

Will the dog be left alone while the family members are at work/school?
—Please choose an option—NoYes
If Yes, on average how long?

Are you willing to safely confine/crate the dog indoors when you are away?
—Please choose an option—NoYes

Would you allow a member of Sunshine Corgi Rescue to visit your home prior to the adoption?
—Please choose an option—NoYes