Adoption Application

1
Your Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
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Ghana
Gibraltar
Greece
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Guadeloupe
Guam
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Guinea-Bissau
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Hungary
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India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Phone Number* This field is required.
Please enter a valid phone number.
5
Date of Birth (Under 21 cannot apply)* This field is required.A parent may apply for those under 21
6
Keep in mind, If there are multiple applications on one horse, you may meet the horse, but we may allow other suitable applicants to also meet the horse to look for the best fit. * This field is required.If you agree to the above, please select YES. It No, do not continue with the application
YESNO
7
Spouse / Partner's Name, if it applies
8
Boarding Barn Name, Number and Address (if you will board)If applicable. Please include social media link, if possible, if boarding
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Is this an application for the Appalachian Trainer Face Off?
YESNO
10
Best time for a volunteer to call you? ** This field is required.
11
Height / Weight of Rider this application applies to (this helps us suggest the right horses to you during the process) ** This field is required.
12
Employer Name and your work title, as well as length of time employed ** This field is required.
13
Yearly Household Income (you will need to verify all income amounts submitted. DO NOT APPLY if you are not comfortable providing proof of your income) ** This field is required.
14
Which HOP horse(s) are you most interested in? *If you will not consider other potential horses, please state so below, as well
15
Have you adopted from a rescue before? If so, which group(s)?* This field is required.
16
Do you have horses now? If so, how many? * This field is required.A sale, placement or euthanasia does NOT disqualify you
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17
Have you ridden independently of a trainer, stable or lesson instructor? * This field is required.
18
Tell us about your equine experience as it relates to giving care and riding; What is the area where your horsemanship needs most improvement? Do you take lessons, attend clinics or pursue continuing horsemanship education? ** This field is required.Short answers are acceptable, as you will also chat about this in your interview on the phone
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Describe Your Feeding routine for horses. What grain do you use, what type of hay and amounts offered daily or per feeding for your current horses. If you are a beginner, describe the boarding facility's or your planned routine: * ** This field is required.Short answers are acceptable, as you will also chat about this in your interview on the phone
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20
If you own horses, you must have yearly teeth floats on your horses. If you do own, please describe Your current Dental Care routine for your horses(s). ** This field is required.Short answers are acceptable, as you will also chat about this in your interview on the phone
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If you are a beginner owner, in order to be APPROVED, you will need to be working with an experienced lesson provider or trainer. Please tell us about your plans to work with a trainer, take riding lessons and/or about the program you're already taking part in. TYPE N/A if you are not a beginner owner. ** This field is required.Short answers are acceptable, as you will also chat about this in your interview on the phone
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If you currently have horses, how often does your farrier visit? ** This field is required.
23
If you currently have horses, in order to be approved, your current horses must have seen a vet at least once in the last twelve months year for an exam and/or vaccines or coggins. Do your horses(s) see a vet once year? *If your horses haven't seen a vet at all in around ONE year, please have a wellness visit before applying:
24
REQUIRED - if you currently own horses provide Vet name, practice name, number and/or email. * This field is required.DO NOT SUBMIT WITHOUT A VET reference if you currently have horses, please
25
If you do not have a current large-animal vet reference, you will be required to board at a facility that has a record of routine care for 12 months. Type N/A if you have a current equine vet and will not be boarding. *
26
REQUIRED - if you do NOT currently own horses provide your family PET Vet name, practice name, number and/or email.Type N/A if you have provided equine vet information above. *
27
REQUIRED - if you currently own horses provide Farrier name, number and/or email. * This field is required.Type N/A if you do not currently own horses: *
28
REQUIRED - if you do NOT currently own horses provide Farrier name and number and/or email YOU PLAN TO USE (You must contact this farrier prior, so they expect our call to confirm) * This field is required.TYPE N/A if you have provided farrier information above: *
29
REQUIRED - Name, number and/or email of Trainer, Lesson instructor or other equine professional or peer who can talk about your skill level: ** This field is required.
30
REQUIRED: List One Professional Reference name, number and/or email. (NO friends or family members.) This person should be a work associate, employer, club member, church member or someone else that knows you in a professional setting. Also List One Personal Reference (NO relatives, but friends are ok) name, email or number. You will send each person an email form they can send back to us linked HERE. You can also find it on the horseandridermatch.com site* This field is required.
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31
Do you understand the rescue does not allow horses adopted from HOP to be given away, bred, or sold. * This field is required.
YESNO
32
Do you understand that ANY adopted horse will take time to settle in a new home and environment. We ask that you please allow a minimum of 14 days in a new home offering patience and understanding before considering the return of a horse. ** This field is required.
YESNO
33
Do you understand the rescue refunds, when requested, the adoption fee paid, (up to a MAX. of $800) upon the re-adoption of the horse when a horse is returned? ** This field is required.
YESNO
34
Have you read HOP's adoption policies and adoption agreement found at * This field is required.
YESNO
35
Have you ever taken part in controversial equine training or handling techniques or been convicted of animal neglect or abuse? ** This field is required.
YESNO
36
Do you understand that All equine activities, including those at Heart of Phoenix, are inherently dangerous and that any and all equines can be unsafe? ** This field is required.
YESNO
37
Heart of Phoenix encourages and will allow for a Pre-Adoption Exam at the adopter's expense to ensure that the horse should be able to perform to the abilities required by an adopter. While this isn't required, it is recommended. Check here to acknowledge you have read you have the option to have a PPE done by a vet of your choice prior to adoption: ** This field is required.
I HAVE READ THIS OPTION
38
Driver's License (you may cover up your DL number, if you wish) * This field is required.required *
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Verification of Income (please mark out your social security number)* This field is required.Required *
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BARN PHOTO - REQUIRED * This field is required.required *
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Current Horse Photos, if applicable Required, if you currently have horses. Please provide a full body side shot with no tack or blankets covering the body.*
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42
Current Horse Photos, if applicableRequired, if you currently have horses. Please provide a full body side shot with no tack or blankets covering the body. *
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Max. file size: 10.6MB
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43
Fence Photos* This field is required.Required *
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Please submit your riding video - A link to youtube, dropbox, google drive is acceptable - to heartofphoenixwv@gmail.com.
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Link to your website or social media, if it applies
46
APPLICATION FEEPLEASE PAY THE $18.00 APPLICATION FEE BEFORE SUBMITTING
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First Name
Last Name
Credit Card Number
Security Code
Card Expiration
47
I, the undersigned, understand I am applying to adopt an equine(s) from Heart of Phoenix Equine Rescue, INC (hereinafter referred to as HOP).* This field is required.
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