Horse Donation Application Horse Donation Name * Name First First Last Last Address Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Phone * Email * Horse Information Horse's Name * Breed * Year Foaled * Gender * Gelding Mare Height * Describe Your Horse's Build (i.e. stocky, thin, average, etc.) * Horse's Location * How Long Have You Owned This Horse? * Why Are You Considering Donating This Horse? * If you have a recent photo of your horse, please upload it here (full body shots are best!) Drop a file here or click to upload Choose File Maximum upload size: 3.15MB Do you have a video of the horse being ridden? (if it's online, please provide the link here) * Training & Temperament Questions What Type and Amount of Work is the Horse Currently Doing? English, Western, Trails, Driving, etc., and Times Per Week: * What Prior Training Does Your Horse Have: * Would You Allow a Beginner Rider on your Horse in an Indoor Arena Setting? * Yes No Able to Walk-Trot-Canter Easily (and stay sound)? * Yes No How Sensitive is your Horse to Leg Aids and/or other Stimulus? * Is your Horse Quiet, Spooky, Calm, Nervous, Confident, Insecure, Dominant, or Submissive? * Please Describe Any Health Problems, Soundness Issues or Injections Your Horse may have Received: * Describe Your Horse's Ground Manners (leads easily, stands quietly, girthy, etc.)? * Health/Feeding Current Grain, Medications, and Supplements: * Any Special Shoeing Requirements? * Date Horse Was Last Shod or Seen by Farrier * Is your Horse Current on Rabies, Coggins, Worming, and Vaccinations? * What is your horse's turn out schedule? Is he/she with other horses? Is your horse on hay/grass/both? * * Behavior Any Vices? (weaving, cribbing, etc.) * Is this horse quiet and well behaved when: In a Stall? * Yes No When Being Led? * Yes No When Being Groomed? * Yes No When Being Tacked? * Yes No Riding in an Indoor Arena? * Yes No Riding on Trails? * Yes No Trailering/Traveling? * Yes No Mounts/Dismounts? * Yes No Does this horse safely: Ground Tie * Yes No Cross Tie * Yes No Lunge * Yes No Load * Yes No Bathe * Yes No Clip * Yes No If "No" to any of the above, please explain: Trial Process When do you need to place the horse? * Could you provide transportation? * Yes No Could you allow a trial of 30 days or longer? * Yes No Are you interested in underwriting any expenses for this horse during the trial period or (potentially) while this horse is on our staff? * Yes No Some of themSome of them If "Yes" or "Some of them" please clarify Are you interested in your horse returning back to you when he/she is ready for retirement from our program? * Yes No I certify that I have truthfully answered the provided questions to the best of my knowledge. (Remember- our therapy horses work with riders with special needs, it is vitally important that we know about their "quirks" before they pop up in our program!) Signature Clear reCAPTCHA If you are human, leave this field blank. Submit
