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Midwest Horse Adoption Program
Adoption Application

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Print off, fill out and send to the address at the bottom of this page.

Please send application to:

MHAP

13358 530 st.

West Concord, MN 55985

 

 

You must have a vet...farrier....and personal reference to be approved!

 

Application

E-mail address:______________________Please make sure that you use the proper capital letters and smaller case letters where needed.

Your Name: ________________________________________________________________________

Address: ___________________________________________________________________________

Zip: __________

Home Phone: ____________________________

Work Phone: ____________________________

What are you looking for in a horse?

1. Gender:              (     )  Gelding                    (     ) Mare                        (    )  Stud

  

2.  Do you have an age preference?

             (  ) No       (  )  Yes    Specify: ___________________________________________

  

3.  Do you have a color preference?

             (  ) No       (  )  Yes    Specify: ___________________________________________

  

4.  Training :   (   ) Western        (    ) English       (    )  Trail     (    ) Ranch work

                                (     ) Other    Please Explain:____________________________

  

5.  Size:          (    )  14 - 15 Hands               (    )  15 - 16 Hands            (    )  16+ Hands

  

6.  Bone Structure:    (   )   Small     (   )  Medium       (   )  Large

Some background Information on you would be helpful....  Please complete the following questions.

7.  Weight and height of person(s) riding:     ____ft  ____lbs;   ____ft    _____lbs

____ft  ____lbs;   ____ft    _____lbs

8.  What would you use the horse for:

(   )  Pleasure/Trail Riding        (   ) Driving        (   )  Showing

(    )  Handicap or Youth Program       (    )  Other       Please Explain:______________________

     

Occasionally other horses become available through referrals made by horse clubs, veterinarians, and

by word of mouth.  Please list any breeds which you may be interested in adopting:

 

______________________________________________________________________________________________

 

 

          9.  Please check all that apply:

                  (   )  I am experienced and intend to break the horse to saddle.

                  (   )  I would like to hire my own trainer to break the horse.

                 

 

          10.  Responsibility for care:

                  A.  Have you ever been responsible for the care of a horse before?     (    ) Yes      (    ) No

                         If yes, how long ago and to what extent?  ______________________________________________

                    

                          ________________________________________________________________________________

 

                  B.  Will the horse be boarded on your property?     (    ) Yes      (    ) No

                         If no, where will the horse be boarded? Please include contact name, address, and phone number __________________

                    

                          ________________________________________________________________________________

 

                  C.  Describe in detail the shelter the horse will have:  ________________________________________

 

                         _________________________________________________________________________________

                    

                  D.  Size of turnout area:  ________________________________________

 

                         What kind of fencing surrounds this turnout area:_________________________________________

 

                         How long will horse be turned out each day:_________________________________________   

 

                  E.  Who will be responsible for the daily care of the horse:  ___________________________________

                         Is this person:    (    )  experienced         (    )  inexperienced      (   )  somewhat experienced

 

                  F.  Please tell us what type of hay will be provided:  ________________________________________

 

                                    How much per day:_________________________________________

 

                         What type of grain will be provided:_________________________________________   

 

                                    How much per day:_________________________________________

 

                         Will horse have free access to water:_________________________________________   

 

 

The Midwest Horse Adoption Program requires references in order to consider an adoption.  Please

complete.  Do not use immediate family members.

 

                  1.  Horse vet or boarding vet:  ___________________________________________________

 

                        Address:  _________________________________________________________

 

                         Phone:  _____________________   How long have you used this veterinarian?  _____________

 

                  2.  Personal Farrier:  ___________________________________________________

 

                        Address:  _________________________________________________________

 

                         Phone:  _____________________   How long have you used this farrier?  _____________

 

                  3.  Personal Reference:  ___________________________________________________

 

                        Address:  _________________________________________________________

 

                         Phone:  _____________________   How long have you known this person?  _____________

 

 

Miscellaneous

Please list any animals you already have:  _________________________________________________________

 

_____________________________________________________________________________________________

 

Are you interested and capable of caring for an injured horse?   (    )  Yes     (    )  No

 

Would you be interested in not only adopting, but in doing foster care  for the horses in our program  (horse that

needs a place to stay until the are placed in permanent homes)?     (    ) Yes    (   ) No

 

Applicant Signature:  ___________________________________________________________________________

 

MHAP  would like it if you could send pictures of you farm, shelter, and turn out area.  You can send pictures

of your animals, also.  Please remember we may have to visit your place before we place a horse there.  This is to

ensure that the horse has a good place to go!  If you have anything else to add,  please do so on the back of a page.

 Thank You!!!!!!!

 

Please spread the word about our program!!!!!

 

13358 530 ST West Concord, MN 55985