Manitou Equine Rescue and PMU Foal Placement ~~ Adoption Application ~~ *Note* MER = Manitou Equine Rescue
	Name:___________________________________________________ Address: ________________________________________________                 _________________________________________________ Phone:  Home:___________________Work:_______________________Cell/Pager:___________________ Email:  ___________________________________________________ Date of Birth: ________________________ Social Security Number: ________________________________________ Drivers License Number ___________________________ State Issued ________________________ Have you owned equines before?  Y / N If yes please explain if you still have them and if you do not have them what happened to them: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Do you own the property where the adopted equine will be maintained?  Y / N If yes... will the adopted equine be kept at the address above? Y / N If no please provide the COMPLETE owners name, address and phone number where the adopted equine will be kept: Name: _____________________________________________ Address: ___________________________________________                ___________________________________________ Phone: _____________________________________________ Please give a description of the area that the adopted equine will be maintained in... please include type of fencing, shelter and turn out schedule (if applicable) ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Please list any other animals that you own now. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Name of Vet: _____________________________________________ City/State: _______________________________________________ Phone: ___________________________________________________ Name of Farrier:___________________________________________ City/State: ________________________________________________ Phone: ___________________________________________________ REFERENCES:  We need atleast 4 and 2 of them must NOT be family members: Name: ___________________________                           Name: _____________________________ City/State: _______________________                           City/State: _________________________ Phone: __________________________                            Phone: _____________________________ Years Aquanted: _________________                            Years Aquanted: ____________________ Name: ____________________________                         Name:_______________________________ City/State: ________________________                         City/State: ___________________________ Phone: ____________________________                        Phone: _______________________________ Years Aquanted: ___________________                        Years Aquanted: ______________________
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