Adoption Application

Adoption Application

 

Adoption Application

New England Equine Rescue – North (NEER North) requires all adoption applications be submitted with photographs of the pastures, fencing, barn and stalls, and any other horses/donkeys at the facility where the potential adoptee will be kept. NEER North may request additional information or pictures to complete its review and may require a visit to your facility before your application will be approved. All information must be completed in full. Thank you.

General Information

Date of Application *

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

Home or Cell Phone *

Work Phone *

Email *

Occupation *

Is there a specific horse or donkey you are interested in? *

What brings you to NEER North? Please tell us a little bit about about yourself and what you are looking for. *

Please list the name, address and telephone number of your current veterinarian and farrier that will be caring for the equine:

Veterinarian *

Phone *

Time Used *

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

Farrier *

Phone *

Time Used *

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

References

Reference 1 (First and Last Name) *

Phone *

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

Reference 2 (First and Last Name) *

Phone *

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

Additional Information

Who will care for the equine if you are sick, injured or otherwise unable? *

What is your experience with equines? *

Do you own a trailer? *

Yes

No

Have you or do you currently own and care for equines? *

Yes

No

Please describe:

What is the intended use for this equine? *

Companion only (No Riding)

Riding

If riding, please select all possible answers: *

Pleasure riding only

Endurance riding

Jumping

Barrels, Poles, etc.

Trail riding

Dressage

OtherOther

If you plan on riding, how often?

Equine Housing

Will the equine be stabled on your own property?

Yes

No

If you answered yes to this question, please answer the following:

How many acres do you own?

How many pasture acres will the equine have?

Total number of equines?

Types?

Have you sold any horses or ponies in the past five (5) years, and if so, what were the reason(s) for selling?

If the equine will be stabled at a boarding facility (or on someone else’s farm or property), please provide the following information:

Name of the boarding facility or farm:

Name of barn owner:

Phone

Number of equines at this facility:

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

Whether on your property or at a separate facility, please provide the following details:

Type of shelter available for this equine?

Barn, run-in, etc.

If a barn, please provide the number and size of stalls

Type of fencing is used for pasture

Type of water system in summer/winter

Feeding schedule and type of food

Amount of hay and grain per equine per day. If pasture fed, indicate which months and what feeding system is used in the winter

Please upload photos of equine shelter, turn out and fencing: *

Drop a file here or click to upload Choose File

Maximum file size: 516MB

PNG or JPG files only, 8 files maximum.

Have you ever been charged with animal abuse or surrendered an equine?

Yes

No

If yes, please describe:

Agreement

Will you submit a Veterinarian Certification and picture of the adopted equine to NEER North every year for three (3) years? *

Yes

No

Intial *

Date *

If you cannot keep the adopted equine, you will return the equine at no charge to NEER North. And that if NEER North cannot receive equine due to space limitations, you will give NEER North at least three (3) months to try to find space. If at that time NEER North still does not have space you will work to place the equine; however, if you sell the equine it is understood that the contract you signed upon adoption will transfer to the equine buyer and a copy of the transferred contract with appropriate signatures and dates will be provided to NEER North.

Intial *

Date *

The equine may not be bred. In the case the equine is accidentally bred, any offspring are the property of NEER North.

Intial *

Date *

I, the undersigned, understand I am applying to adopt an equine from NEER North. I agree that I have read and understand the adoption terms and responsibilities, including those requiring financial, labor and time commitments. I also understand that I must complete the application process and my facility (home or boarding barn) must be approved before being allowed to adopt any equine from NEER North. I understand that I may not be able to adopt the equine I want for various reasons. I agree and understand that NEER North reserves the right to request a background check to verify personal information. I agree not to hold NEER North liable in the event of injury, death, or damage to any human, animal or property as a result of activities or actions of the equine I adopt.

I HAVE CAREFULLY READ, CLEARLY UNDERSTAND, AND VOLUNTARILY SIGN THIS ADOPTION AGREEMENT.

Type Your Name to Acknowledge Agreement *

Date *

Upon submitting this form you will be redirected to PayPal to send your $15 adoption application fee. You can pay using a credit card or by logging into PayPal.

When completed this form will be emailed to [email protected]. NEER North appreciates the contribution of all fosters and adopters and your willingness to help us save and protect horses from neglect, cruelty and slaughter.

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