Professional References:

Name of your veterinarian:

Telephone:

City:

State:

Zip Code:

Name of your farrier:

Telephone:

City:

State:

Zip Code:

Personal References:

References should be someone, unrelated to you, with knowledge of your horsemanship skills, or if you are new to horses, your skills with animals. If you are new to horses, please include the name of the friend or trainer who will be helping you with your horse.

Name:

Telephone:

Relationship:

Name:

Telephone:

Relationship:

Name of trainer helping adopter:

Telephone:

Horse property information - Do you?

Own Property

Rent Property

Board

Describe shelter, type of fencing, number of acres and number of other horses on the property:

If boarding, please complete the following:

Name of Facility:

Contact Name:

Telephone:

City:

State:

Zip Code:

If renting, please complete the following:

Name of Landlord:

Telephone:

Have you obtained permission from your landlord to keep a horse on the property?

Yes

Please list the equines currently in your care with age and breed:

Briefly describe your horse experience and training philosphy:

Anything else you would like us to know?

I certify that all the information contained herein is true and correct:

Your Signature

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