Name of applicant:_____________________________________________________
Address:_____________________________________________________________
____________________________________________________________________
Home Phone:__________________ Work Phone:____________________
Employer:____________________________________________________________
Address: _____________________________________________________________
How long have you been employed by above:_________________________
Annual Income:________________________
If you rent your home:
Landlord's Name:______________________________________________________
Landlord's Phone:______________________________________________________
Will the horse be kept on your property?---Yes________ No________
If yes, describe the area and shelter provided:
____________________________________________________________________
____________________________________________________________________
If no, list the address and description of the boarding/training facility:
____________________________________________________________________
____________________________________________________________________
Trainer/Manager and Phone: _____________________________________________
Do you currently own a horse?---Yes_____No_____How many?___________
If yes, please describe: _________________________________________________
If you previously owned a horse, please explain what happened to it: ____________________________________________________________________
What type of horse are you specifically interested in?
Age________________Breed:__________________
Height:______________Range of training:_________________________
What is the height and weight of rider(s): __________________________
Briefly describe your level of expertise in the following areas:
Riding:
_____________________________________________________________________
_____________________________________________________________________
Handling:
_____________________________________________________________________
_____________________________________________________________________
Training:
_____________________________________________________________________
_____________________________________________________________________
Have you ever gentled and/or trained a wild (feral) mustang, or similar horse?---Yes____ No_____
If yes, please describe the methods you used: _____________________________________________________________________
Who will ride the adopted horse?___________________________________
Who will be responsible for feeding your horse:________________________
Training your horse:____________________________________________
General care of your horse:_______________________________________
How much do you anticipate spending yearly for feed? __________________
Medical care?________Worming? _________ Farrier?________________
How often do you feel a horse should be wormed?_____________________
How often do you feel the hooves should be trimmed?___________________
How often should the teeth be floated? ______________________________
How often should a horse receive vaccinations?________________________
Who will be your veterinarian? _______________________
Phone: ______________
Who will be your farrier? __________________________
Phone: ________________
Why do you want to adopt a horse? (use the back for more information) ______________________________________________________________________
Have you ever been issued a warning/citation for humane violation?---Yes__________ No_____
If yes, please explain: ______________________________________________________________________
Wild Horse Foundation would like to inspect your property/barn, when would be a convenient time? ______________________________________________________________________
Please provide three references:
Name: __________________________Phone: _____________________
Name:___________________________Phone:_____________________
Name:___________________________Phone:____________________
I/We certify that all the information contained herein is true and correct.
Affidavit
I, _____________________ give the Wild Horse Foundation full authority to enter said property wherever the adopted horse or burro is located by giving full consent to any local law enforcement/city or county officer and by consenting to authorize any county, city or state district judge to issue said warrant of seizure to obtain said adopted horse or burro.
Signature:___________________________________ Date:______________________
Signature:___________________________________ Date:______________________
Before me appeared said individual above gives sworn statement to be true and correct.
Notary: ____________________________ Date:_______________
Notary Seal
Send donations to:
Wild Horse Foundation, P O Box 692, Franklin, Texas 77856
Phone for more information: 979.828.3927 or email grfield@wildhorsefoundation.org
© 1998-2007 Wild Horse Foundation