Adoption Application Form

Personal Details
Name*
First Last
Postal Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Is your residential address the same as your postal address?*
- Yes
- No
Residential Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth*
MM slash DD slash YYYY
Email*
Mobile Phone Number*
Home Phone Number*
Job Title*
Name of Employer*
What other pets or livestock do you have?*
Have you ever been issued a citation, warning or been convicted of animal cruelty?*
- Yes
- No

Facility Details
How many acres will the equine have access to?*
What kind of shelter do you have (barn/stalls, loafing sheds, windbreaks, etc.?*
What kind of fencing do you have?*
What is the total number of equines on the property?*
Do you have a trailer?*
- Yes
- No

Additional Questions
Why are you interested in adopting a horse?*
I understand that placing horses is at the discretion of Have a Heart Equine Sanctuary*
- Yes
- No

References
It is our practice to contact references. These include personal acquaintances, veterinarians, and farriers.
Reference Name 1*
First Last
Reference Mobile Phone Number 1*
Reference Email Address 1*
Reference Name 2*
First Last
Reference Mobile Phone Number 2*
Reference Email Address 2*
Confirming application*
By submitting this form, I attest that all of the information in this application is true to the best of my knowledge
Name*
First Last
Date*
MM slash DD slash YYYY
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Personal Details