Mending

Hope Equine Rescue

337 Townline Road Fairmount City, PA, 16224

m.h.equinerescue@gmail.com

Adoption Application

Adopter Information:

Name ______________________________________________ Email (if any)_________________________________________________

Address_____________________________________________________ Phone – Home (_______) ______________________

City ____________________________ Zip Code __________________ Cell (_______) ______________________

Driver’s License Number ___________________________________

Do you work Full time? Part time?

_________________________________

Equine Requirements:

Application for: Horse Pony Miniature Horse Donkey Mule

Is there a specific animal at Mending Hope Equine Rescue? _________________________________

Is there a specific breed/height/age you prefer? _________________________________________________________________

What level of training would you prefer the equine to have?

Untrained Started Green Moderate Experience Well trained

What riding discipline is your primary focus? ________________________________________________________________

How often will the equine be ridden/driven? _________________________________________________________________

What is your overall goal for your adopted equine? __________________________________________________________

Rider Information:

How long has the primary rider been riding? ___________________________________________

Please select the most appropriate skill level of the primary rider:

Beginner – very little, if any, experience riding/handling horses

Advanced Beginner – able to apply basic aids, comfortable at walk & posting trot

Intermediate – confident riding walk, trot, and canter on a quiet, reliable mount

Advanced Intermediate – can W/T/C regularly, jump a course, can communicate with horse effectively

Advanced – confident, independent seat, soft hands, can handle a spirited horse

Trainer – highly skilled, can start & finish horses, can handle young/difficult horses

Does the primary rider work with a trainer or riding instructor? If yes, please tell us who:

Name: __________________________________________, Phone (______) __________

Facility Information:

Where will this animal be living? Boarding facility Private residence

Address ______________________________________________________________________________________________________

Who owns this property? Please list phone number _____________________________________________________

What is the approximate size of the turn-out area? ______________________________________________________

What type of fencing is used? ______________________________________________________________________________

What will be used for shelter? stall run-in shed other shelter ___________________

Who will be handling this animal on a daily basis for feeding, watering, and turning out?

_________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________

Who will care for the animal when you are unavailable to do so (vacation, illness, etc.)?

_________________________________________________________________________________________________________________

Please list the farm animals you currently own or owned in the last 2 years.

Species/Breed Age Sex Neutered? If no longer owned, what happened to the pet?

_________________________________________________________________________________________________________________

Which veterinarian will you use for equine care?

Name ______________________________________________________

Phone number (_______)___________________________________

What farrier do you intend to use for this animal?

Name _______________________________________________________

Phone (_______)_____________________________________________

This information will be

used to help provide you with the best possible equine match.

By signing, I affirm that I am 21 years of age or over, and the information contained on this form is

true to the best of my knowledge.

____________________________________________ __________________________________

Signature Date

*Please provide pictures of current animals.

*Please provide pictures of turn out areas.

Fencing requirements:

**All unhandled horses must have six foot high sturdy fencing.

Mending Hope Equine Rescue does not allow barbed wire fencing.

*Pre-purchase exams by your veterinarian