Phone Number: ________________________

What is the intended use of the horse? _____________________________________________

Will the horse be stabled on your own property or boarded out? _______________________

If on your property, number of acres the horse will be pastured on: _______________

Total number of horses on this property: ________________

Is the property where the horse is stabled on the same as the address above? _________

If boarded on someone else's property:

• Name of boarding stable: ____________________________________
• Address of boarding stable: __________________________________
• Phone number with area code: _______________________________

What shelter do you have for the horse, (i.e. barn, run-in shed)? ____________________________

If you have a barn:

• Number of stalls; __________
• Size of stalls ______________

How many horses do you currently own? _______________

Have you sold any horses on the past 5 years? ________

Please list the name and phone number of your present veterinarian or the vet you plan
to use for equine care: ______________________________________________

Please list two additional references familiar with your care of and experience with horses:

_____________________________________________

_____________________________________________

Please describe your experience with horses:

________________________________________________________________________

Describe the type of horse you are seeking (i.e. size, sex, temperament, etc)

________________________________________________________________________

Is there a specific animal that has been posted that you'd like to adopt? _____________

Please note here: ________________________________________________________________

My signature also attests that I am not a member of Lasso Horse Rescue

SIGNATURE: ______________________________________

Printed Name: _______________________________________

Date: _____________________

Please print out, fill in, sign, and mail to:
LASSO
1360 Terry Robinson Road
Pagosa Springs, CO 81147
OR Fax to 970-731-2828.