Date

Your Name*

Address

Country

Phone Number*

Ownership Information

1. Which horse are you interested in and why?

2. How many horses have you owned in your lifetime - where are they now?

3. Describe your experience with the following:
Riding (how many years, what disciplines):

Handling:

Training:

Working with young or unbroken horses (if applicable)

4. Please list all other family members (or friends) that will be responsible for caring for this horse or riding it (their ages and experience).

5. Do you have a particular trainer that you work with?

6. How often to you worm, vaccinate or float teeth?

Please list name and phone # of your current veterinarian who you plan to use for equine care:

7. How often do you trim/shod?

Please list name and phone # of your current farrier or who you plan to use for equine care:

8. Who will care for the horse if you go out of town?

Environment

1. Will the horse be kept on your property?

If the property belongs to someone else, please list name and contact info.

2. Number of acres the horse will be pastured on:

3. Total number of horses on this property:

4. Describe the breed and gender of the other horses:

5. Describe the area and shelter to be provided (photographs are appreciated if possible!)

Size of shelter:

Size of barn:

Size of stall:

Type of fencing:

6. If you are boarding at a facility

Name of boarding stable:

Name of owner:

Address:

Phone Number:

7. How much do you anticipate spending yearly for:

Feed:

Farrier:

Veterinary care:

Board:

8. Have you ever been issued a warning/citation, or been convicted for humane violations?
If so, please explain:

I/WE CERTIFY THAT ALL OF THE INFORMATION CONTAINED HEREIN IS CORRECT AND TRUE.