Adoption Questionnaire

Address: P. O. Box 1000 Altoona, IA 50009 Email: iowahart@gmail.com
Adopter Questionnaire:
Thank you for your interest in adopting from Hope After Racing Thoroughbreds! To help us ensure that one of our horses is the right fit for you please complete the following questionnaire in full. A representative will contact you upon reviewing your questionnaire with any additional next steps. Please keep in mind we are a volunteer run organization and the screening process may take 10 -14 business days.
Personal Info
Full Name:
Parent or Guardian if Rider is under 21 yrs old:
Rider's Age:
Rider's Height and Weight (to help us best match you with compatible horses)
Contact Info
Complete Home Address:
Phone Number:
Format: (000) 000-0000.
Alt Phone Number:
Format: (000) 000-0000.
E-mail Address:
example@example.com
Financial Info
What is your household's net annual income?
Will there be anyone helping you pay for the care of your horse? If yes, please explain.
How much do you estimate it will cost per year to own your adopted horse. Please provide a breakdown.

Horse Experience and History
How many years have you been working with horses and in what capacity/disciplines? Provide Details.
Have you ever leased or owned a horse? Provide Details.
Do you have experience working with off-track Thoroughbreds?
How would you rate your riding ability?
You and Your Potential Horse
What qualities would you like in a horse? (e.g. age, color, sex, size, temperament)
What style and level of riding do you wish to achieve?
Are you working with a trainer? If yes, who and how often? Provide contact information.
Does your trainer have experience working with off-track Thoroughbreds or other green horses? If no, are you willing to find a trainer who does, if necessary?
Will there be anyone else riding the horse? If yes, explain their experience.

Are you considering a mare for breeding purposes? If yes, please list your experience with breeding and foaling.
Are you interested in a specific horse(s)? Please list.
What is your timeline for adopting?
If you have an unforeseen life event, what would be your plan for your adopted horse?
How did you hear about our program?
Facility Info
Please provide Contact Information for the facility at which the horse will reside.
Name:
Owner:
Address:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Do you live at this facility?
If you do live at the facility, what do you anticipate paying per month to care for the horse?
If boarding, do you currently or have you boarded at this facility in the past? Please specify.
What is the monthly board fee? What does it cover?
Will your horse be kept primarily in a stall or pasture?
What type of fencing surrounds the pastures and paddocks? Please list all materials.

Care & Feeding Info
How many times per day will your adopted horse be fed? Please explain.
Where will the horse be fed (e.g. stall or pasture)?
What type of grain and hay will the horse be fed? Are you willing to change to accommodate the horse if needed?
What is your planned vaccination and deworming schedule?
What is your planned farrier schedule?
Please provide the contact information for the veterinarian you intend to utilize.
Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Are you currently a client?
Please provide the contact information for the Farrier you intend to utilize.
Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Are you currently a client?
Personal References:

Provide two NON-FAMILY references that are experienced with horses and are aware of both your horse experience and the facility at which you intend to keep the horse.
Name:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Relation:
Name:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Relation:

Adoption Contract Info
Have you read the 'Adoption Contract' and do you agree to the terms and rules governing adoptions from HART?
Do you both understand and agree to submitting written and visual updates on the adopted horse at three (3), six (6), and twelve (12) month intervals post adoption?
Are you familiar with HART's Return Policies? Please note that it can take some time for a horse to be returned to the program. Returns are taken in as space is available although exceptions may apply in the case of an emergency.
BY SIGNING OR TYPING YOUR FULL NAME BELOW, YOU CERTIFY THAT ALL OF THE
INFORMATION THAT YOU HAVE PROVIDED ON THIS APPLICATION IS TRUE AND CORRECT
TO THE BEST OF YOUR KNOWLEDGE.
Name
Signature
Date

MonthDayYear
Date
Name (Parent or Guardian if minor signed above)
Signature
Date

MonthDayYear
Date
Thank you for taking the time to read and understand the application. Please proceed to processing your $25 application fee. Our volunteer team will begin processing your application and will follow up with you whenyou have been approved. Please note that this may take up to 10 business days.
Once approved you will be scheduled to come and meet the horses!
Should be Empty:

Adopter Questionnaire: