AHDF Application for Assistance1 (4)

The Arabian Horsemen's Distress Fund, established in 2005, is a non-profit organization that was created to help members of the Arabian horse community during time of difficulty that arise from unexpected, catastrophic events.

To be eligible for assistance, an applicant must meet the following criteria:

Be a curent member in good standing of the Arabian Horse Association (AHA)

Be a widow/widower, spouse or dependent of a member in good standing of the Arabian Horse Association (AHA)

Be willing and able to substantiate said need in writing and supply the Board members with whatever documentation is requested.

Please see the website at www.horsemensdistressfund.com for additional guidelines regarding the AHDF. The Board of Directors retains the final interpretation of all guidelines, and has full and final discretion as to the dispensation of funds.

The AHDF is not able nor meant to replace insurance, nor are situations surrounding poor business management eligible for assistance. Deductible amounts not covered by insurance may be submitted.

If you do not hear back from us within 24 hours of submission of this automatic form, please text Mary at 860-488-7074 or email mary@trowbridgesltd.com to be sure it has been received.

Remembering that the AHDF is a bridging fund for events immediately following an unexpected crisis, please explain the situation that has prompted you to apply to the AHDF. *

Applicant Best Phone Number*

Applicant Name*

Mailing Address*

Email Address*

example@example.com

AHA Member Number*

How many years have you been a member of AHA*

Do you have health insurance*

If yes print name of company*

What is your annual deductible*

Do you have farmhome insurance*

If yes print name of insurance company*

What is your deductible*

List your household's TOTAL NORMAL MONTHLY INCOME here, include all income streams. Notate which, if any, amount is impacted by the reason for this application here.*

How many horses do you or your family own*

How many are Arabians or Half Arabians*

How many horses do you take care of or have on your property*

Please provide an itemization of the bills and amounts you are requesting the fund's assistance with here *

Mortgage/Rent Payment *

Insurance car*

Vehicle Payment(s)*

Insurance-- health and home*

Utilities (Electric, Gas, Water, etc)*

Childcare*

Other mandatory monthly payments, please include monthly credit card minimum payments*

Feed*

Farrier*

Board*

Veterinarian*

Labor*

Please sign below that the information you have provided is complete and correct. As the AHDF is a charitable organization that is supported 100% by donations, personal testimonials are crucial to the ongoing survival of this entity. Signature of this document also attests to your willingness to assist with on-going testimonials, fundraising and personal support of the AHDF whenever possible.*

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