| Volunteer Equine Advocates, Inc. |
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| © 2006 Volunteer Equine Advocates, Inc. Photos and all other material found in this web site may be used ONLY with the written permission of VEA. |
| Volunteer Equine Advocates, Inc. P O Box 112 Gallatin, TN 37066 615-832-3005 send email |
| Click on the above link to a .pdf version of the form. You will need to have Adobe Acrobat Reader installed on your computer to open this file. |
| or print this page and mail the completed application to: Volunteer Equine Advocates, Inc. P O Box 112, Gallatin, TN 37066 Someone will contact you as soon as possible to begin your interview and to schedule a site visit |
VEA Membership / Equine Foster / Adoption Application
Membership Information: (All fosters / adopters must become VEA members @ $25
annually).
Name: __________________________________________________________________________________
Address: ________________________________________________________________________________
City, State, Zip __________________________________________________________________________
Home phone: _____________________________ Work Phone: ________________________________
Email address: __________________________________________________________________________
Date of birth: _____________________ Current Employer: __________________________________
Years with this Employer:_______ Employer’s Address: ____________________________________
Have you ever been charged with or convicted of animal abuse? __________________________
If yes, please explain.
_________________________________________________________________________________________
Confidentiality Statement: I understand that certain information pertaining to Volunteer
Equine Advocates may be confidential in nature and that I am to use discretion in
discussing policies, current cases and other related issues with non-VEA members. I also
understand that it is my privilege as a VEA member to be party to certain email lists, and
that no email messages that I receive from these lists may be forwarded to anyone not
belonging to that list without first obtaining permission from an officer of VEA. I have read,
understand, and agree to adhere to the statement outlined herein.
Signature _________________________________________________ Date________________
Equine Experience
1. Do you currently own equines or have you owned equines in the past? Explain
___________________________________________________________________________________________
___________________________________________________________________________________________
2. In the past five years, have you given any equines away or sold any equines? Explain
___________________________________________________________________________________________
___________________________________________________________________________________________
3. In the past five years, have you had any equines in your care die? Explain
___________________________________________________________________________________________
___________________________________________________________________________________________
4. Please describe your experience with handling, caring for, riding, and training
equines.
___________________________________________________________________________________________
___________________________________________________________________________________________
Complete this section to apply to Foster:
These questions are to help determine what animals you would most like to foster. Feel free
to explain any stipulations you may have or any concerns you may have on the back of the
application.
Place a check mark next to which of the following you would be willing to foster:
_______Horse______ Pony______ Mule_______ Donkey________ Miniature (horse, donkey)
Would you be willing to foster an equine that has been seized by law enforcement while its
owner awaits a hearing (the owner could be awarded the animal back by a judge)?
__________________________________________________________________________________________
Would you be willing to foster a horse with training issues? If so, please explain your own
training experience._______________________________________________________________________
___________________________________________________________________________________________
Would you be willing to foster a horse with health issues?__________________________________
Would you be willing to foster an old horse?________________________________________________
Would you be willing to foster a horse that's too young to ride? _____________________________
Would you be willing to foster a stallion or a newly gelded animal?__________________________
Would you be willing to foster an equine you cannot ride?__________________________________
Comment - ________________________________________________________________________________
___________________________________________________________________________________________
Complete this section to apply to Adopt (In addition to all of the above)
Number and name of equine you wish to adopt:
___________________________________________________________________________________________
Type of activities planned for this equine?
___________________________________________________________________________________________
___________________________________________________________________________________________
How much time per week will you spend with this equine?
___________________________________________________________________________________________
If you will be using the equine for riding, please list the names and ages of the people who
will be riding the equine:
___________________________________________________________________________________________
___________________________________________________________________________________________
If the equine will be kept at a location other than the address given above, please list the
name of the facility, address, contact person, and phone number:
___________________________________________________________________________________________
___________________________________________________________________________________________
Reference Information: (required to foster and adopt)
Please list the name, address, and phone number of the equine veterinarian you will be
using ____________________________________________________________________________________
__________________________________________________________________________________________
Please list the name, address, and phone number of the equine professional (farrier or
trainer) you will be using
___________________________________________________________________________________________
___________________________________________________________________________________________
Please list the name, address, and phone number of a personal reference
___________________________________________________________________________________________
___________________________________________________________________________________________
No foster / adoption application will be approved until references are confirmed from
a veterinarian, equine professional, and personal reference.
All fosters / adopters must be members. If you are not a member of VEA, you can
join at this time.
I, the undersigned understand I am applying to foster / adopt (circle one) an equine
from Volunteer Equine Advocates. I understand that I must complete the application
procedure and have my home (or boarding facility) approved before being allowed to adopt
an equine from Volunteer Equine Advocates. I understand that I may not be able to adopt
the equine I want for various reasons.
In addition, I understand that Volunteer Equine Advocates, Inc. may perform a
background check on me to verify my personal information as well as check for any criminal
convictions.
By signing this application, I agree that I have read and understand the adoption
policies of Volunteer Equine Advocates. I understand that I must submit a complete
adoption application in accordance with the Volunteer Equine Advocates, Inc. Adoption
Policy before being considered to adopt. I understand that if I do adopt an equine from
Volunteer Equine Advocates, Inc. that I will be subject to home visits in accordance with the
VEA Inspection Policy. I also understand that, in accordance with the Adoption Policy, I
may never sell at auction, or sell / send to slaughter the equine I adopt.
By signing this application, I agree not to hold Volunteer Equine Advocates liable in
the event of injury, death, or damage to any human, animal, or property as a result of
activities or actions of the equine I foster / adopt.
In addition, I, the undersigned, have read and understand the following warning:
WARNING
UNDER TENNESSEE LAW, AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY
TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE
INHERENT RISKS OF EQUINE ACTIVITIES, PURSUANT TO TENNESSEE CODE
ANNOTATED, TITLE 44, CHAPTER 12
Applicant Date
Approved Date