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Beauty’s Haven Farm & Equine Rescue, Inc. Where Life Begins, Again!

A 501(c)(3) Non-Profit Organization

ADOPTION APPLICATION Please read the application thoroughly before you fill it in.

You can fill this pdf document out using Adobe Reader available at: http://get.adobe.com/reader/otherversions/

Name of the equine(s) (horse, donkey, or mule) you are applying for (if known):

Is this an individual or joint application? Individual Joint Corporate

If joint, the other co-applicants must also fill out a separate copy of this form and

complete the sections with a blue font like Name/Age. The person or persons signing the

adoption contract must fill out an application! The primary adopter must fill out the

complete application.

Do you live in the same household? Yes No N/A

NOTES AND OTHER CONSIDERATIONS:

Adoptions are currently restricted to the state of Florida although exceptions have been made. We will not adopt to homes in Broward and Miami-Dade Counties.

We will not adopt horses to homes with barb wire fencing or open water.

We do not normally adopt out to a boarding situation.

BHFER owns and will be a safety net for this horse for the rest of its life – if the adoption doesn’t work out or there is a change in circumstance and the adopter can no longer care for the horse, the horse will be returned to BHFER.

Some horses may have other restrictions regarding adoptive homes, based on the horse’s past and current condition.

Adoptions are processed on a case by case basis. Please note that BHFER reserves the right to approve or deny a potential adoptive home at BHFER’s sole discretion. We do not have to tell you any or all the reasons.

Before you submit your application, have you thoroughly thought about the expense of owning a (average 1000 lb.) horse? Below are some example costs associated with horse ownership. If you are not financially able to support the equine don’t fill out:

$250 for grain and hay, each month $35-$55 to have the feet trimmed, approx. every 6 weeks (trim only)

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$4 - $12 for wormer, every 6 weeks $300+ for the annual vet visit, vaccinations, Coggins test $125+ for the equine dentist, every year At least 1-2 hours each day to feed, clean stalls/pasture, and groom the horse Miscellaneous expenses such as fly spray, grooming items, and tack Funds to cover an emergency – i.e. colic hospitalization/surgery $3000+

If the horse becomes ill and requires medical attention, this can range from a simple vet call and exam for $50, or could be in the thousands (i.e. colic surgery).

Our goal is to adopt each horse into a forever home, where it will be happy, safe, and loved for the rest of its life. Do you have the will?

ABOUT THE ADOPTER AND HOUSEHOLD

Name/Age: Email Address(s):

Aliases:

Home Phone as (123) 456-7890: Cell as (123) 456-7890: Work Phone as (123) 456-7890:

Last 4 #’s of SSN: Facebook Page: Other Online Profiles/Pages:

Address:

How long have you lived at this address? __________________________________________

If less than 2 years please provide previous residence address:

___________________________________________________________________________

Employer Name*: Address: Part or full time?

# of Years:

Phone as (123) 456-7890:

* If less than 2 years please provide previous employer’s name and address.

Annual Income (check one): Less than $20K $20K - $30K $30K – 50K Over $50K N/A

1. How many dependents do you have?

2. Please list the full names and ages of all other persons 18 years of age and older that live in the household:

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FINANCIAL RESPONSIBILITY:

We have found that a typical 1,000 lb. equine costs about $4,000 per year to own (See previous page for details). Explain who is going to be financially responsible for this equine and what is their source of income?

REFERENCES

(Make sure to tell them we will call to discuss your ability to care for an adopted equine)

1. Vet: Phone as (123) 456-7890:

2. Farrier: Phone as (123) 456-7890:

3. Personal: Phone as (123) 456-7890:

If you have volunteered or worked at any equine or animal rescue organization not listed above, please list someone from that organization as a reference.

Your Reference’s Name and Organization’s Name:

Website and Phone:

WHERE WILL THE ADOPTED EQUINE(S) LIVE?

1. Do you currently own a horse or other equine? Yes No If so, describe:

2. Describe the type of run-in, corral, or stall that will be provided (include size):

3. Will the equine live on your own property? Yes No If not, provide the name, address, and phone number of the facility: NOTE: Approval for boarding is by exception only!

4. Do you own (or have a mortgage) or lease your property? Own Lease

ADOPTER’S RIDING EXPERIENCE (if you intend to ride):

1. Height & weight: ft. lbs.

2. Height and weight of other person/people who will be riding:a. ft. lbs. b. ft. lbs. c. ft. lbs.

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3. Are you an experienced rider; somewhat experienced; limited in experience;or an inexperienced rider; non-rider?

4. How long have you been riding horses? ___________________

5. Use of the horse:

Dressage Jumping Western

Trails/Pleasure Lesson program Youth program

Handicap program Companion or Pasture Pal

Other Use(s) (please explain)

6. How many times per week will the horse be ridden?

7. Please check all of the following that apply:

I am experienced and intend to ride and train by myself.

I would like to hire my own trainer or instructor.

I would like to hire a trainer or instructor, but do not know of any.

8. How long have you taken lessons with a professional instructor?

9. If you use a trainer or instructor, or plan to use a trainer or instructor, please provide theirname and contact information:

10. Have you been involved with organized horse groups? Yes No If so, which one(s)? If you no longer participate, why did you leave?

RESPONSIBILITY FOR CARE:

1. Have you ever been responsible for the care of an equine before? Yes No If yes, how long ago and under what circumstances?

2. If you have not owned an equine in some time, will you be enlisting the help of an equineprofessional to work with you with care? Yes No

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3. Please list any other animals you now have, the type, and their names:

4. Do you foster and/or board horses for others? Yes NoIf so, are they managed in the same facilities the adopted horse would be in?

Yes No

5. Do you put incoming horses into quarantine? Yes No

6. What type of fencing do you or the facility have (please include size of turn-out areas)?

7. How many hours will the horse be turned out each day?

8. Under what conditions do you stall a horse and for how long?

9. Specifically, who will be responsible for daily care?

10. Who will care for the adopted equine if you have to go out of town or are unable to carefor the equine for any amount of time?

When it comes to the care of horses, is this person: experienced; somewhat experienced; or inexperienced?

11. If care is to be provided by persons who are not adults, please list their names, ages,and the name of the person who will be supervising them:

12. What type of hay will the horse be fed?How much and how often each day?

13. What type of grain will you provide?

How many times per day?

How is your grain stored?

14. Do/will you provide clean water for your horses 24 hours per day? Yes NoWhat is your water source? ______________________________________________

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15. Do/will you provide a plain white salt block and a brown trace mineral block for yourhorses 24 hours per day? Yes No

16. What is your de-worming plan?

How often?

What type of wormers?

17. How is manure disposed of?

18. How often will/do you have your farrier trim or shoe?Do you plan on shoeing the horse? If so, why?

19. How often will/do you have your horse’s teeth examined?

20. Has anyone in your household been charged or convicted of a crime against animals orhumans? Yes No If yes, please explain.

21. Has anyone in your household been charged/convicted of a crime regarding alcohol ordrugs? Yes No If yes, please explain.

Knowledge of basic horse care (answers on Internet or a good book):

1. For what reasons would you call your vet?

2. List the signs of colic:

What would you do if you notice these signs?

3. List the signs of Choke:

What would you do if you notice these signs?

4. What are some of the causes of sudden lameness?

What would you do if you notice these signs?

5. What is founder and what would be the first clue it is occurring?

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What would you do if you notice these signs?

6. How long should you wait after feeding to ride?

7. How long should you wait after riding to feed?

8. How far is it from where the horse will live to the vet’s office?

What are your plans if your vet is not available for an emergency call?

Do you have a backup vet? If so, who?

Directions to your farm or stable from the nearest major road or highway intersection:

BHFER requires pictures or drawings of the shelters and turn-out areas where you intend to keep your horse whether this is at your farm or another facility. These pictures will be returned promptly if you include a self-addressed envelope or you can email us digital pictures that we can keep with your file!

Draw the layout of your facility in this space or on a separate sheet of paper:

Comments:

We would like to know what you believe is the "ideal" horse for you. We welcome any additional comments and description in the space provided.

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What would you do with your adopted horse should the horse become unsound or unfit for riding? If you do not intend on keeping the horse for its lifetime, even if it becomes unsound for riding, please do not fill out this application. Our goal is to find good, forever homes for the equine(s).

NOTES AND OTHER CONSIDERATIONS:

If you are prepared for this commitment and are financially able to support this equine(s), for life, please and forward your application to BHFER.

By my signature or printed name (if you don’t have a digital signature), I attest to the fact that everything stated in this application is true and factual and I understand any false statements can result in immediate removal of the adoption horse from my facility. Yes No

In addition, I understand that BHFER may perform a background check on me to verify my personal information, including credit history, as well as to check for criminal convictions.

Yes No

If you have a digital signature, sign here:

Signature of Co-Applicant Dates

Otherwise type your name(s) in the boxes below:

Printed Name of Primary Applicant.

Beauty’s Haven Farm & Equine Rescue, Inc. Fax: 352-528-9227 Phone: 352-258-9309 PO Box 53 Morriston, FL 32668 Email: bhfer@earthlink.net