HORSE ADOPTION APPLICATION
PERSONAL INFORMATION:
HORSE OR PONY THAT YOU ARE INTERESTED IN: ____________________________________________________
NAME OF PROSPECTIVE ADOPTER:_______________________________________________________________
CURRENT ADDRESS: ________________________________________
________________________________________________________
HOW MANY HORSES DO YOU CURRENTLY OWN? ______________________________________________________
HOME PHONE: ___/___/____ WORK PHONE: ___/___/____
CELL PHONE: ___/___/____ EMAIL: _______________________________
CURRENT EQUINE VETERINARIAN AND CLINIC NAME: _________________________________________________
ADDRESS: ________________________________
________________________________________
CLINIC PHONE: ____/____/_____ NUMBER OF YEARS USING CLINIC: _____________________________________
OTHER CLINICS/VETS AND PHONE # USED IN THE PAST 5 YEARS: ________________________________________
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FARRIER: __________________ PHONE# ___/___/____
EQUINE DENTIST: ______________ PHONE #___/___/____
TRAINER: __________________ PHONE#___/___/____
PLEASE PROVIDE 3 EQUINE REFERENCES:
_______________________ PHONE# ___/___/___
_______________________ PHONE# ___/___/___
_______________________ PHONE# ___/___/___
WHO WILL BE CARING FOR THE HORSE? ___________________
WHAT TYPE OF FENCING DO YOU HAVE?____________________________________________________________
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WHAT AND WHERE ARE YOUR WATER SOURCES?_____________________________________________________
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DO YOU HAVE ELECTRIC AT YOU BARN? YES____ NO ____
WHAT SHELTER (BARN/STALL, RUN-IN SHED) WILL BE AVAILABLE TO THE ADOPTED HORSE?____________________
___________________________________________________________________________________________
WHAT IS YOUR INTENDED USE OF THE ADOPTED HORSE? ______________________________________________
___________________________________________________________________________________________
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Thank You For Your Support!
Pheasant Hill Equine Foundation, Inc.
4911 Bald Hill Road
Adamstown, MD 21710
Phone: 301-432-2344
Fax: 301-874-6949
Email: phequinefoundation@yahoo.com
www.phequinefoundation.org