Corgi Rescue Program
Please complete ALL contact sections so we can contact you.
Please type your full name and date below.
May we give your phone number to approved applicants who may be interested in the dog?
Additional comments or information
As owner/agent, I relinquish all rights, transfer ownership and make available for adoption through Columbia River Pembroke Welsh Corgi Club the Pembroke Welsh Corgi described above. I certify I am the owner, free and clear of any other interests or co-owners.For, and in consideration of, said placement effort, I relieve CRPWCC of all liability for any act in connection herewith.
How does the dog react to being left alone in the house?
How does the dog react to being left alone in the car?
How does the dog react to being left alone in the kennel run?
How does the dog react to being left alone in a fenced yard?
Does the dog know any tricks or have any favorite pastimes?
Does the dog have any obedience, agility, rally or other training?
Does the dog have any familiar response words?
How does the dog react to women?
How does the dog react to children?
How does the dog react to strangers?
How does the dog react to other dogs?
How does the dog react to cats?
How does the dog react to men?
Does the dog (check if yes):
Walk on a leash?
Come when called?
The dog is(check if yes):
Any supplements or medications? Please list.
Do you have current health/shot records
Do you have a current rabies certificate?
Do you have a pedigree?
What is your veterinarian's name, city and telephone number?
What preventive medications is the dog on?
Other, please list below
What brand of food? Dry or canned?
Reason for release:
Do you have the registration papers?
What identifying marks does the dog have?
What color is the dog?
Red & white
Is the dog neutered or spayed?
AKC Registration Number:
If yes, what is the chip or tatoo number?
Does dog have a microchip or tatoo?
What is the dog's sex, age and weight?
Pembroke's Call Name
Pembroke's Registered Name:
Thank you for contacting us!
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