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Midwest Horse Adoption Program
Adoption Questionnaire

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If you are interested in adopting or fostering a horse from MHAP, please complete the following application and mail it in with a $5.00 processing fee to the address at the bottom of the questionnaire. If you have any additional questions about adoption, please feel free to email us. Thank you.

Name:__________________________________

Address:_______________________________

____________________________________

____________________________________

Are you over 18 yrs old?

Please tell us about your experience with horses:

What will you use your horse for? (i.e. trail, family pet, show, other):

Please discribe in detail where your horse(s) will be residing. Will you board or keep it on your property?

What type of fencing will you use for your horse?

Will your horse have free access to shelter and water? Please explain:

What will your feeding schedule be? Please add what type of feed.

Discribe your routine vet care: (i.e. how often you give shots,worming):

Name of vet you will use:_______________________________

Phone number of vet:_______________________________

Discribe your routine farrier work:

Name of farrier you will use:_______________________________

Phone number of farrier you will use:_______________________

Please list other animals you have:

Please list two personal references with phone #'s:

Please add any other information you would like us to know about yourself. Pictures of your facility are highly encouraged, but not necessary.

Email Address:_____________________________________

Phone:___________________________________________

Please read the following adoption agreement. To qualify for adoption, questionaire must be completed, dated, and signed. Qualifing for adoption does not obligate you to adopt.

I agree that the said adopted horse will be given the best of care while in my posession. I agree that the said horse will NOT be neglected, abused, starved, or mistreated in ANY way. I agree that if I adopt a mare I will not have it bred. I agree that the adopted horse will remain in my custody for a time period of at least 1 year (365 calander days). I agree within the first year, I will allow a representitive of MHAP check up on the horse if necessary.

_______________________________________
Signature

_________________________________
Signature of Parent if under 18 yrs

Send Adoption Questionnaire with your $5.00 processing fee to:

Midwest Horse Adoption Program
C/O Judy Roal
13358 530 ST
West Concord, MN 55985