PLEASE TYPE YOUR ANSWERS

IN, THEN PRINT .

YOUR FULL NAME:

YOUR STREET ADDRESS (AND PO BOX):

YOUR CITY, STATE, ZIP CODE:

YOUR HOME TELEPHONE NUMBER:

YOUR HOME E-MAIL ADDRESS:

YOUR WORK TELEPHONE NUMBER:

YOUR WORK E-MAIL ADDRESS:

YOUR FAX NUMBER:

DO YOU CURRENTLY OWN A HORSE?� YES OR NO:

IF YES, HOW MANY?

DO YOUR HORSE(S) LIVE AT YOUR BARN?� YES OR NO:

IF BOARDED, WHO MAY WE CONTACT? (FULL NAME)

NAME OF BARN:

STREET ADDRESS:

CITY, STATE, ZIP CODE:

TELEPHONE NUMBER:

E-MAIL ADDRESS:

WHAT TYPE

OF FENCING

�WILL BE

�PROVIDED?

CLICK HERE to go to page 2 of the adoption prospectus.

What breed of horse would you prefer?

(please list in order of preference)

1)

2)

3)

4)

What is your color preference?

(please list in order of preference)

1)

2)

3)

What is your preferred sex?

(Mare, Gelding, Stallion, Any)

Are you interested in a Premarin foal?

Yes or No: