A little Rescue
2554 Lincoln Blvd, # 1032, Venice, CA 90291
alittlerescue501c3@gmail.com 805.379.8511

ADOPTION APPLICATION

Date:

YYYY

Applicant Name:

First Name

Last Name

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone:

Country

(###)

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####

Email:

Horse(s) interested in adopting from ALR:

1. Please describe the riding experience of the applicant, including years of riding, date of last riding lesson (if applicable), showing experience, training experience, past or present horse ownership experience:

2. Please give your riding level:

Beginner Intermediate Advanced Advanced Beginner Advanced Intermediate Trainer

3. Please state whether you currently work with a riding instructor or trainer and provide the name and address of such individual, if applicable:

Please type yes or no

Name:

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

4. Where will you keep your horse? Including rental property, owned property, boarding facility, or other. Photographs of the field in which the horse will reside and the barn in which the horse will be stabled must be attached. The physical address of the facility or property must also be provided:

Please type: rental property, owned property, boarding facility, or other.

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

5. Please state whether an individual other than the applicant will be responsible, in whole or in part, for expenses incurred during horse ownership. If your answer is in the affirmative, please give the full name, address, and contact information for each such individual:

Please type yes or no

Name:

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone:

(###)

###

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6. Please describe the type of horse(s) you are seeking so that we can add you to internal search lists for adoptable animals:

Equine age: Equine height: Color preference: Gender: Intended use: Price range:

7. References:

Please provide the name, current address and telephone number for each of the following references: a. Equine Specialist (trainer, coach, instructor, knowledgeable acquaintance): b. Veterinarian: c. Non-family character reference:

By checking this box, I acknowledge that I am required to complete and submit the following documents in order for the application to be reviewed: Equine Professional Reference Letter, Veterinarian Reference Letter, and Character Reference Letter.

Required Reference Documents Acknowledgment

Adopter Signature:

First Name

Last Name

Date:

Please type today's date:

DOB:

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Country

(###)

###

####

Parent/Guardian (if minor):

First Name

Last Name

Date:

Please type today' s date:

Relationship:

Trust or rescue representative name:

First Name

Last Name

Date:

Please type today's date:

Title:

By signing this form, prospective adopter grants ALR, its agents and employees, the right to do Internet searches, physical facility visits, check with named references or use other information to determine whether to approve the signor. Once approved, an adopter is added to the ALR list and may request consideration for adoption of any ALR equine. Approval does not convey any right to adopt a particular horse.

ADOPTION APPLICATION

THANK YOU FOR YOUR INTEREST IN ADOPTING FROM OUR RESCUE!!!