Cell Phone Number: ... Have you read SCER-GA Adoption Contract in detail? Yes No. Do you disagree with SCER-GA Adoption
Adoption Application A $5 application fee is required to submit an application and is NON-REFUNDABLE. Please pay via PayPal to
[email protected].
First Name: __________________ Last Name: _____________________ Email address: ______________________________ Telephone Number: ____________________ Cell Phone Number: _________________ Address: ________________________________ City: _______________State: _______Zip: __________ Employed by: ___________________________ Title: _________________ Length of Employment: ________________________________ Address: ______________________________Telephone: _____________ City: __________________ State: ___________ Zip: ___________ Current Annual Income _______________ Highest level of Education Completed _______________ When is the best time to have a telephone interview? ___________ Applicants MUST be over 21 or have a parent complete the application. Yes, I am 21 or older
No, I am not yet 21.
Can you afford all care costs of an adoptive horse typically averaging $3500 per year? Yes No Which horse(s) are you interested in, if approved to adopt? ____________________________________________________________ Where will the adopted equine be housed? Boarding
Address above
Other than address above
Boarding Facility/Other than home address Address: ________________________________ City: _______________State: _______Zip: __________ Years of equine experience? ______ Number of horses currently owned? ___ Number of horses owned one year ago? ___ Have you had a horse die or euthanized in the last 5 years? No
Yes, Please describe circumstances
____________________________________________________________ ____________________________________________________________ ____________________________________________________________
Do you breed or intend to breed equines?
Yes
No
Rate your equine handling and riding abilities. 1
2
3
4
5
6
7
8
9
10
Never Ridden
Equine Professional
Have you sold, leased, given away, or auctioned any equine in the past 10 years? No Yes, Please explain. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Do you have any stallions on your property?
Yes
No
Please explain why adoption through Second Chances is important to you. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Explain your goals for an equine partner. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
Select the types of horses you are most interested in. Young, unstarted Beginner Friendly Gaited Non – Gaited Gelding Mare Over 15h Under 15h Show Trail Pasture Pet/Companion Miniature Describe Your Boarding Facility or Personal Farm Layout. Acres, Type of Fence, Type of Shelter. Explain whether the equine would be stalled or on turn out. If the equine will be stalled, how often and how many hours will they be turned out daily? ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Describe your feed, deworming, farrier, dental, and Veterinary routine. If you are a beginner, describe the boarding facility or planned routine. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Please list three attributes about Yourself that you feel are your important assets. ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
References 1. Business/Professional Name: _____________________________ Telephone: (____) ______-________ 2. Personal Name: __________________________________ Telephone: (____) ______-________ 3. Trainer/Instructor: __________________________________ Telephone: (____) ______-________ 4. Farrier: __________________________________ Telephone: (____) ______-________ The equine veterinarian who will care for this animal is: Name: _______________________________ Address: __________________________________ Telephone: (____) ______-________ Do you understand that adopting from Second Chances Equine Rescue works similarly to an Equine Lease? No
Yes
Do you agree that approval or denial of this application is at the sole discretion of SCER-GA, to never make negative public statements about the organization based on denial of this application, and not to harass SCER-GA based on the application being denied? Yes
No
Have you ever taken part in controversial equine training or handling techniques or been convicted of animal abuse or neglect? No Yes Please explain ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Have you read SCER-GA Adoption Contract in detail? Yes
No
Do you disagree with SCER-GA Adoption Policy or Contract in any manner? No Yes, Please explain ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Do you understand that all equine activities, including those at Second Chances Equine Rescue Inc. are inherently dangerous and that all equines can be unsafe? Yes No Please submit identification and facility photos to
[email protected]
I, the undersigned, understand that I am applying to adopt an equine from Second Chances Equine Rescue Inc. I understand that I must complete the application procedure and potentially have the property or boarding facility inspected before being allowed to adopt. I understand that I may not be able to adopt the equine I am interested in. I am welcome to reapply after 90 days if denied. I understand that SCER-GA will check to verify my personal information and references. I agree to notify said references in advance. I understand that SCER-GA does not know the history of many of their equine and if approved for adoption, will handle and ride the equine at my own risk. By signing this application, I agree that I have read and understand the Adoption Contract found at www.scer-ga.org. Printed Name: ______________________ Application Fee $5.00 Signature __________________________ Date ____________
