E-mail Address: * Name of Horse(s) you are applying to adopt: * Name of Adopter (note: must be 18 years of age or older): * Date of Application: *
Address * City * State (Note: at this time, we only adopt within western WA state): * WA Zip Code * Day Phone * Evening Phone * Cell Phone Which Number do you prefer we use? * Day Phone Evening Phone Cell Phone Best time of day to contact you? * Mornings Daytime Evening Occupation * Length of Employment * Annual Household Income * Less than $25,000 $25,000-$40,000 $40,000-$75,000 $75,000 or more Do you have the financial capability to care for a horse? Take into account veterinary expenses, boarding, farrier visits, tack, training, unexpected emergencies, etc. * If this horse is not available, would you consider a different horse? * If yes, what type of horse are you interested in? Describe age, breed, height, training, etc. Why are you interested in adopting a rescue horse? * Are you willing to consider a horse with limitations? * Have you or anyone in your immediate family ever been arrested, charged, or found guilty of any crime involving animals? * Do you have any mental or physical limitations which may limit or could limit in the future your ability to care for a horse for its lifetime? * Do you anticipate any major life changes in the next 10-20 years which could limit your ability to keep a horse for its lifetime (i.e. moving across country/overseas, retirement, having children, income changes due to college expenses, etc.)? * I would like a horse for: (check all that apply) * Other (please describe): Please provide THREE personal references, preferably those that can speak to your horse experience. Only one may be a family member. Reference 1 Name: * Reference 1 Relationship: * Family Friend Co-Worker Other Reference 1 Phone Number: * Reference 2 Name: * Reference 2 Relationship: * Family Friend Co-Worker Other Reference 2 Phone Number: * Reference 3 Name: * Reference 3 Relationship: * Family Friend Co-Worker Other Reference 3 Phone Number: * Name of veterinarian you will use for adopted horse: * Veterinarians Phone Number: * I am currently a client of this veterinarian: * If you have a horse(s) currently or previously (within last 5 years) and have used a vet other than the one listed above, please provide their name: Alternate Veteriniarians Phone Number Name of Farrier you will use for adopted horse: * Farriers Phone Number: * I am currently a client of this farrier: * If you have a horse(s) currently or previously (within last 5 years) and have used a farrier other than the one listed above, please provide their name: Alternate Farriers Phone Number: Trainer/Instructor (Optional, required for first-time horse owners): Trainer/Instructors Phone Number: Do you currently own any horses? * If yes, please describe (age, breed, sex, purpose): If no, have you previously owned a horse(s)? If you have previously owned a horse(s), was the horse(s) sold, given away, or died (list age and cause of death): How often do plan to vaccinate your adopted horse? * Semi-Annually Annually Every 2+ years I do not vaccinate Type of vaccinations given (check all that apply): Date of last vaccinations for currently owned horse(s): How often do you plan to worm your adopted horse? * Every 2 months Every 3 months Every 6 months Yearly Never What type of worming program do you plan to use for the adopted horse(s)? * Daily Wormer Rotational paste wormer Targeted based on fecal results Other Date of last worming for currently owned horse(s) Will your adopted horse be shod or kept barefoot? * Shod Only Barefoot Only Depends on individual horse How often will your adopted horse be trimmed/shod? * Every 5-8 weeks Every 9-12 weeks Every 3-6 months Never Date of last farrier visit for currently owned horse(s): How often will your adopted horse have a dental exam and/or teeth floated by a licensed veterinarian? * Every 6 months Yearly Every 2-5 years Never Date of last dental float for currently owned horse(s) Describe your horse experience (length of time, training received, type of riding, pleasure or competition, etc.): * Briefly describe your training philosophy: * If you are adopting a ridable young or unstarted horse, please explain your training plan for getting the horse started under saddle: Describe where the horse will be kept. Number of Stalls/Shelters Available: * Number of acres in pasture/turnout: * Number of horses currently on property: * Available Shelter (check all that apply): * Other Shelter (please describe) Type of Fencing used in turnout area(s) (check all that apply): Other Fencing (please describe): Where will the horse primarily be kept? * Boxed Stall Stall with attached paddock Paddock Pasture Other How many hours of turnout a day will the horse receive? * No Turnout 1-4 hours 4-8 hours 8-12 hours Unlimited How often will the adopted horse(s) be exercised typically (outside of turnout)? * 5-7 times a week 3-4 times a week 1-2 times a week Less than 4 times a month Never Is there a winter mud management plan in place? * Please describe: Describe your feeding program (include types of feed, frequency of feedings, whether horses are fed individually or in a herd, etc.): * Do you own or rent the property where the horse will be kept, or will you be boarding the horse? * Own Rent Board If you own or rent a property, how long have you been there? Less than 6 months 6 months-2 years 2-5 years 5+ years >If you rent, do you have permission from your landlord to keep horses? Landlords Name: Landlords Phone Number: If you will be boarding your horse, what is the name of the Stable where the horse will be kept? Barn Owners Name Barn Owners Phone Number: Address of Stable: Are you currently or have you previously been a boarder at this facility? What type of boarding arrangement will you have? Full Care Self Care Partial Care Work off board I have read and understand the Adoption Policies as outlined on the SAFE website. I hereby certify that the information provided in this adoption application is accurate and complete: * * Required Create Your Own Contact Form
