ADOPTION APPLICATION
Save a Horse Ride a Rescue

Beech Brook Farm Equine Rescue

Beech Brook Farm Equine Rescue requires ALL applications be submitted with photographs of the pastures, fencing, barn and stalls, and any other horses/ponies at the facility where the horse/pony/donkey will be kept Beech Brook Farm Equine Rescue may request additional information or pictures to complete its review and may require a visit to your facility before your application will be approved.

There is a $15 dollar application fee. Payment made______(internal office use)

General Information

Full Name: ______Age: ______

Address: ______

Town: ______, State: ______Zip Code: ______

County: ______Telephone Number (with area code): ______

Email Address: ______

Work Telephone Number: ______Occupation:______

Willyouagree to Beech Brook Farm Equine Rescue requirements that a Veterinarian Certification and picture of the adopted horse/pony be submitted to Beech Brook Farm Equine Rescue every year for three (3) years.

Yes/No ______(initial and date)

Will you agree that if you can not keep adopted horse that you will return the horses at no charge to Beech Brook Farm. If Beech Brook Farm can not take horse due to space limitations you will agree to give Beech Brook Farm at least 3 months to try to find space and if at that time Beech Brook Farm still does not have space you can work to place the horse however if you sell the horse it is understood that the contract you signed upon adoption will transfer to the buyer and a copy of the transferred contract with appropriate signatures and dates will be provided to Beech Brook Farm. Yes/No______(initial and date)

Questions

1. If there is a specific horse or pony you are interested in, please state the name of that horse or pony. ______

2. Please list the name, address, and telephone number of your current veterinarian and farrier that will be caring for your horse or pony?

Veterinarian: ______

______

Farrier: ______

______

3. What is your experience with horses? ______

______

4. Have you owned and cared for horses before: Yes/No describe: ______

5. What is the intended use for this horse or pony? Please place an "X" next to all possible answers:

______Companion (no riding) ______Pleasure riding only ______Trail riding

______Jumping ______Barrels, Poles, etc. ______Endurance riding ______Dressage

6. Will the horse be stabled on your own property? ______

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

a. If your own property, how many acres do you own? ______

b. How many pasture acres will the horse/pony have? ______

c. How many horses and/or ponies do you currently have? ______

d. Have you sold any horses or ponies in the past five (5) years? ______. If yes, what were the reason(s) for selling: ______

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

a. Name of the boarding facility (or farm)______

b. Owner’s name of the boarding facility or farm: ______

c. Address of the boarding facility ______

______

d. Telephone number of the boarding facility: ______

e. Total number of horses/ponies at this facility: ______

8. Whether on your property or at a separate facility, please answer the following questions:

a. What type of shelter (i.e., barn, run-in shelter, etc.) will the horse/pony have? ______

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

c. What type of fencing is used for the horse pasture? ______

d. What type of watering system is used in the summer/winter? ______

______

e. What is the feeding schedule and type of food fed? ______

f. How much hay and grain is fed per horse per day? If pasture fed indicate during which months and what feeding system is used in the winter______

______

9. Please list the names, addresses, and telephone numbers of two references familiar with your experience and care of horses that we may contact.

1. ______

______

2. ______

______

10. Do you own a horse trailer? ______

11. Who will care for the horse if you are sick or injured: ______

12. Have you ever been charged with animal abuse? Yes/No. If yes please describe:

______

When completed, please return to: Beech Brook Farm, 125 Fishtown Road, Mystic CT 06355 or you may scan and email to

860-705-8456