| adoption application |
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Note: Adopted horses remain the property
of USERL. Adopters may not breed, race, sell or give away the adopted
horse. Adopters must allow USERL to inspect their facility for safety
prior to adoption, and access to check the horse thereafter at USERL's
discretion. For more information, read our Adoption FAQ.
YOU MUST BE 18 YEARS OR OLDER TO SUBMIT THIS APPLICATION.
If you are a minor, please have your parent or guardian submit this
form. |
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| Please contact webmaster@userl.org
if you have any problems filling out this application. |
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| Date: |
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| ADOPTOR INFORMATION |
| Name: |
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| Address: |
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| City:
State:
Zip:
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| County:
(Note: We are asking for county, not country.) |
| Phone #: (Home) |
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| Phone #: (Work) |
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| Phone #: (Cell) |
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| E-mail: |
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| Have you previously owned a horse(s)?
Yes
No How long ago?
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| Do you currently own a horse(s)?
Yes
No For how long?
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| Do you currently own or rent the property above?
OWN
RENT |
| If renting, name of owner:
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| How long have you lived at the above address?
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| If you are employed, skip to "Current Employer."
If you are not employed, please provide employment information for the
person who will be financially responsible for the adopted horse. |
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| Name of person whose employer information is below: |
| Relationship to this person:
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| Current employer:
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| Employer address:
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| Employer address:
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| City:
State:
Zip:
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| Years employed with this company?
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| List two of the closest relatives not living with
you and who live in different homes: |
| 1ST Name:
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| Phone:
Relationship to you:
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| Address (No P.O. Boxes):
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| City:
State:
Zip:
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| 2ND Name:
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| Phone:
Relationship to you:
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| Address (No P.O. Boxes):
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| City:
State:
Zip:
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| FACILITY INFORMATION |
| Will the horses be kept at the above address?
YES
NO |
| If "No," we need the following information about
the property where the horses will be kept: |
| Name of owner:
|
| Address:
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| City:
State:
Zip:
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| Phone:
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| Number of acres in which horse will be pastured on: |
| Total number of horses on above acreage:
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| Type of shelter the horse will be provided (select one):
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| If "other," please describe: |
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| Type of fencing (USERL does not accept barbed wire fencing):
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| HORSE CARE |
| How much to you anticipate spending yearly for the following:
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| Feed $:
/year |
| Farrier $:
/year |
| Veterinary care $:
/year |
| Board $:
/year |
| What deworming method will be used?
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| How often will deworming be done?
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| How often will you have the horse's teeth checked and
floated?
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| What vaccines will you give and how often? |
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| EQUINE PREFERENCES |
| The more flexible you can be in your specifications, the
more likely it is that we can match you with a horse. 16 hand, dead-broke
quarter horses between 5 and 15 years old rarely make their way to the
USERL. However, we may have a 20 year old, well-broke appaloosa that
would suit you very well. When making your specifications, please make
sure you indicate the absolute maximum and minimum you will accept. |
| If a specific horse interests you, please enter his/her
name here:
|
| Do you need an equine that is or will be rideable?*
Yes
No
Don't Care |
| *(If you answer "yes," you will only be offered
horses that are currently or will in the future be able to be ridden.
If you answer "don't care," you will also be offered horses
that can never be ridded for one reason or another. |
| Please specify any acceptable height range:
hands |
| Please specify any acceptable age range:
|
| Are you interested in (check all that apply):
Horse
Pony
Mule
Donkey |
| What is your breed preference:
|
| Will you consider another breed?
Yes
No |
| Please check the rider's experience level (Make one X
per rider): |
| Has been riding for less than 2 years:
|
| Regularly rides on:
Trails
Pleasure |
| Rides seriously in:
Large shows
Small shows
Horse training experience |
| Is a professional trainer/instructor:
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| I will consider a horse that is (check all that apply): |
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Unbroke
Green-broke
Well-broke
Dead-broke |
What use do you intend for this horse? Please include
such things as age and weight of intended rider, trail riding, pleasure,
jumping, competition, etc. The more information you give us, the easier
and faster it will be to match you with a horse.
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| REFERENCES |
| Please list two references who are familiar with your
care and experience with horses: |
| Name:
Phone:
|
| Name:
Phone:
|
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| HUMANE VIOLATIONS CHECK |
| Have you ever been issued a warning/citation, or been
convicted for human violations?
YES
NO |
| If "Yes," please explain: |
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| I am at least 18 years of age:
YES
NO |
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| I/WE CERTIFY THAT ALL OF THE INFORMATION CONTAINED HERIN
IS CORRECT AND TRUE. |
| Signature:
Date:
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| Signature:
Date:
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If you are unable to submit this form
online, you may print the form and mail it to:
USERL — Adoption Application
P.O. Box 317
Pendleton, IN 46064
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