Adoption/Foster Application

Name

Address

City

State

Zip Code

County

Phone Number

Work

E-mail

What is the intended use for this animal?


Will this animal be stabled or boarded out? 

If on your property, number of acres the animal will be on

Address animal will be housed at

Are you a Present animal owner?
YES        NO
# of years
                                     
Number & type of animals owned

Shelter provided for animals: (barn, stalls, run-in-shed)

Type of fencing provided for horses
                     
Size of Housing
                                                           
Who will be caring for this animal? Please give Name, Age & Date of Birth

Have you sold any animals in the past 5 years? 
YES        NO      
If yes, how many and why were they sold

What is your experience with animals?

Please state if the animal is to be a family animal, expertise of the animal handler(s) and experience of animal

Describe the type of animal you are seeking to adopt/foster:
Size

Age

Sex
Mare        Gelding            Colt/Stallion
Temperament

Soundness

Please describe activities in which the animal will be involved (show, 4-H, jump, drive, companion animal)

If there is a specific animal that has been posted that you would like to adopt/foster, please note here

Is there a type of animal that you do not want to adopt? 

Is this the: 
Veterinarian you plan to use?    or
Your current veterinarian (please mark which)

Veterinarian Name

Address

City

State

Zip Code

Phone


Please provide two additional references (not related) familiar with your experience with animals:

Please have your references complete the form listed below to bring with you, fax or e-mail your reference in.  We will need to know the length of time they have known you and any additional information they feel will help us make a determination in your favor to adopt a horse.

Name #1

Address

City

State

Zip

Phone Number (including area code)

Name #2

Address

City

State

Zip

Phone Number

If boarded, provide the following information

Name/Owner of boarding facility

Address of Facility

County

Phone Number W/ Area Code


Animal Protection Coalition, Inc. will require that all applicants have their information verified prior to acceptance in to the Adoption/Foster Program. Each application must have a written or verbal recommendation from their Veterinarian and two other adults who have knowledge of the applicant for a minimum of two years.

Animals adopted/fostered from Animal Protection Coalition, Inc. include no guarantees regarding soundness or temperament. Animal Protection Coalition, Inc. requires payment of an adoption donation at time of adoption.

Your adoption application will be placed in our files, it is good for two years.  We will make all attempts to contact you if an animal fitting your needs becomes available for adoption, however we ask that you also watch the website.

By submitting this application, you are authorizing Animal Protection Coalition, Inc to perform whatever investigations the Board of Directors authorize to include; criminal background, interviews, credit history, employment history, etc.

Signature - by typing your name, you are certifying you have completed this application and agree to its terms.

Date

I understand by submitting this application I am responsible for obtaining 2 personal references, a vet reference and pictures of the facility where the horse will be housed to have my application processed.