Bright Futures Farm, Inc.
44793 Harrison Road
Spartansburg, PA 16434
Phone: 814.827.8270
ADOPTION/PLACEMENT APPLICATION
Please read out Placement Contract prior to completing this application. We do not use the conventional definition of the term “adoption”. The term adoption, for our purposes, is clearly defined in the Placement Contract. If you have any questions, please ask. If you are uncomfortable with the terms of our contract, we can recommend other agencies to you. These horses are members of our family. We are committed to an above average quality of life and level of care for each and every one of them. If you cannot meet our requirements, please do not apply. Our requirements are simple, but we do enforce our contract. You must provide care and shelter and nutrition as indicated in our Placement Contract.
Additionally, if you do not complete the application in its entirety, or any of the supporting documents we have asked for… do not send the application fee with the application… do not include the required photos, and/or you do not initial and sign the appropriate documents where indicated, your application will not be processed. Please proof read everything and complete our check list at the end of the application before you send it in. If you have not completed it, we will not read beyond the missing information and we will not notify you of missing information.
You always have the option to ask questions.
Thank you.
ABOUT YOU
You must be at least 25 years old and gainfully employed to adopt. If you do not meet these qualifications, you will need to have a parent, guardian or spouse (who is at least 25 and gainfully employed) co-sign for you. A co-signer is equally responsible for the ongoing care of any horse you choose from Bright Futures Farm and the contract in its entirety should you be unable to meet the needs of the horse financially alone.
NAME (as it appears on your birth certificate – if single, or marriage license – if married)
FIRST____________________MI____LAST_________________________JR/SR/I/II/III________
MAIDEN NAME (if married)_____________________________
ADDRESS_________________________________________________________________________
CITY_______________________COUNTY__________________STATE______ZIP_______________
HOME PHONE_______________________ALTERNATE PHONE_______________________________
EMAIL______________________________________________BIRTH DATE_______________________
PROVIDE ONE OF THE FOLLOWING GROUPS OF INFORMATION (A, B OR C):
(A) SS#___________________________
(B) CITY, COUNTY, AND STATE YOU WERE BORN IN_______________________________________
AND LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER__________
(C) YOUR D.L.#___________________________STATE OF ISSUE ________
SINGLE________, MARRIED_________, DIVORCED________, SEPARATED__________
IF MARRIED, DIVORCED OR SEPARATED, HOW LONG___________________________
WHO OWNS THE HOUSE YOU LIVE IN (NAME AS IT APPEARS ON THE DEED)___________________________________
• HOW LONG HAVE YOU LIVED THERE_____________________
IF THE PROPERTY IS NOT IN YOUR NAME, DO YOU HAVE A VERBAL OR WRITTEN AGREEMENT
FOR RESIDENCE______________ WHAT IS YOUR RELATIONSHIP TO OWNER_________________
• IF LESS THAN FIVE YEARS, LIST COMPLETE PREVIOUS ADDRESS BELOW:
________________________________________________________________________________
• IF RENT, NAME, AND PHONE OF LANDLORD:____________________________________
YOUR EMPLOYER________________________________________YEARS THERE_____________
POSITION___________________________________PHONE_____________________________
ADDRESS____________________________________CITY________________STATE__ZIP______
IF YOU ARE SELF-EMPLOYED, LIST THE COMPANY NAME (INCLUDE “INC.”, “LLP”, ETC.)
_________________________________________________________________
STATE OF INCORPORATION_________FEDERAL TAX ID#_________________________
CO-APPLICANT INFORMATION (WHEN APPLICABLE)
NAME (as it appears on your birth certificate – if single, or marriage license – if married)
FIRST____________________MI____LAST_________________________JR/SR/I/II/III________
MAIDEN NAME (if applicable)_____________________________
ADDRESS_________________________________________________________________________
CITY_______________________COUNTY__________________STATE______ZIP_______________
HOME PHONE_______________________ALTERNATE PHONE_______________________________
EMAIL______________________________________________AGE__________________________
RELATIONSHIP TO APPLICANT _____________________________________________________
ARE YOU CURRENTLY EMPLOYED FULL TIME_______HOW LONG___________________
NAME OF TWO NEAREST LIVING RELATIVES – NOT LIVING WITH YOU:
A. _____________________________ ADDRESS:______________________________________
PHONE_______________________ RELATIONSHIP TO YOU____________________________
B. _____________________________ ADDRESS:______________________________________
PHONE_______________________ RELATIONSHIP TO YOU____________________________
YOUR EQUINE VETERINARIAN: ___________________________________PHONE_____________________
ADDRESS__________________________________________________________________
YOUR FARRIER: _____________________________________PHONE____________
YOUR EQUINE DENTIST:_______________________________PHONE____________
HAVE YOU EVER OWNED A HORSE BEFORE _______IF YES, HOW MANY AND WHEN___________________
_______________________________________________________________________________________________
HAVE YOU EVER SOLD OR GIVE ANY AWAY_____IF YES, HOW MANY___________________WHAT WERE THE CIRCUMSTANCES IN EACH CASE:
MANY OF OUR HORSES NEED ADDITIONAL SCHOOLING. FOR THE FOLLOWING QUESTIONS, USE A SEPARATE SHEET OF PAPER IF NECESSARY.
WHAT IS YOUR RIDING BACKGROUND:
WHAT IS YOUR BACKGROUND REGARDING TRAINING A HORSE :
ARE YOU THE ONLY PERSON WHO WILL RIDE THE HORSE YOU CHOOSE_____ IF NO, WHO ELSE WILL BE RIDING____________________________________________________________________WHAT IS THEIR SKILL LEVEL________________________________WHAT IS THEIR HEIGHT________WHAT DO THEY WEIGH_________
HOW OFTEN WILL THIS HORSE BE RIDDEN EACH WEEK________________________________________
HOW MUCH TIME A DAY DO YOU HAVE TO SPEND WITH THIS PARTICULAR HORSE OTHER THAN RIDING OR FEEDING_____________________________
ABOUT THE FACILITY
DO YOU OWN THE PROPERTY ON WHICH THE HORSE WILL RESIDE_____
IF YES, DO YOU ALSO LIVE AT THE SAME ADDRESS_____IF NO, HOW FAR IS IT FROM YOUR HOME__________
IF NO, YOU WILL NEED TO COMPLETE OUR BOARDING ADDENDUM AND INCLUDE A COPY OF THE BOARDING CONTRACT WITH YOUR APPLICATION.
• WILL YOUR HORSE LIVE IN A BARN, RUN IN SHED OR BOTH __________PLEASE LIST THE SIZE OF THE SHED,
AND/OR STALL __________________________________
• WHAT TYPE OF FENCING ENCLOSES THE PASTURE (OR PASTURES) YOUR HORSE WILL HAVE ACCESS TO ______________________________________________________________________________________________
• HOW MANY ACRES IS THE PASTURE (OR PASTURES, LIST EACH SEPARATELY) WILL YOUR HORSE HAVE ACCESS
TO __________________________________________________________________________________
• HOW MANY OTHER HORSES (OR OTHER FARM ANIMALS) WILL SHARE PASTURE WITH YOUR HORSE
_____________
• HOW MANY HORSES ARE ON THE PROPERTY________ HOW MANY FARM ANIMALS (NON HORSE) ARE ON THE
PROPERTY_________HOW MANY DOMESTIC PETS (DOGS, CATS, ETC) ARE ON THE PROPERTY___
• WHAT IS YOUR WATER SOURCE FOR THE PASTURE AND/OR BARN____________________________________
• WHAT GRAIN DO YOU FEED IN THE SUMMER AND HOW OFTEN __________________________________________
• WHAT GRAIN DO YOU FEED IN THE WINTER AND HOW OFTEN____________________________________________
• WHEN YOU FEED HAY DO YOU FEED ROUND BALES OR SMALL SQUARE BALES ____________________________
• WHAT VACCINES, IF ANY, DO YOU ADMINISTER, AND WHEN_____________________________________________
________________________________________________________________________________________________________
QUESTIONNAIRE
WHAT DO YOU KNOW ABOUT COLIC AND HOW TO TREAT IT:
WHAT DO YOU KNOW ABOUT SHOCK AND HOW TO TREAT IT:
DO YOU HAVE A FIRST AID KIT IN YOUR BARN__________IF YES, WHAT IS IN IT RIGHT NOW:
CHECK ALL THAT YOU CAN ACCOMPLISH TODAY WITH NO HELP FROM ANYONE:
_____PULL A SHOE _____TREAT A PUNCTURE WOUND
_____TAKE YOUR HORSES TEMPERATURE _____CALCULATE YOUR HORSES HEART RATE
WHAT SHOULD RESTING TEMP BE?________ WHAT SHOULD RESTING RATE BE? _________
_____CALCULATE YOUR HORSES RESPIRATION _____CHANGE A DRESSING ON A WOUND
WHAT SHOULD RESTING RATE BE?_______
_____KNOW THE SIGNS OF FOUNDER _____KNOW THE SIGNS OF COLIC
_____KNOW THE SIGNS OF SHOCK _____DIAGNOSE A HOOF ABSCESS
_____TREAT A HOOF ABSCESS _____ADMINISTER AN “IM” MEDICATION
_____ADMINISTER AN “IV” MEDICATION _____RECOGNIZE THE SIGNS OF CUSHINGS
_____AID A HORSE THAT HAS CAST IN RISING _____TREAT A BOWED TENDON
SAFELY
_____TREAT OTHER SOFT TISSUE INJURIES _____TREAT A HORSE WITH A BROKEN BONE WHILE
WAITING FOR A VET
_____TREAT A HOOF WITH AN OBJECT IN IT WHILE WAITING FOR A VET
WHAT TYPE OF RIDING DO YOU PLAN TO DO SPECIFICALLY WITH THE HORSE YOU CHOOSE:
NAME OF THE HORSE YOU ARE INTERESTED IN ADOPTING _______________________________
Please sign below to acknowledge that you have read and understood all of the questions contained herein…and to certify that all of the information you have provided to us is correct and that you have not provided any false or misleading information in this application.
___________________________________________________Date____________________________
Applicant
Spouse, Domestic Partner or Co-Applicant: Please sign below to acknowledge that you have also read, and understand all of the questions contained herein…and certify that any information you have provided to us is correct and that you have not provided any false or misleading information in this application.
NOTE: If you are a co-applicant, you are equally responsible for the horses’ care if the applicant should have difficulty providing care at any time or notifying BFF if you wish to return the horse.
Spouse or Domestic Partner is responsible for notifying BFF, immediately.., if Spouse or DP does not wish to be involved in said equine’s care, and applicant becomes unable to physically or financially care for the horse and the horse needs to be returned..
___________________________________________________Date____________________________
Spouse, Domestic Partner or Co-Applicant
PLEASE INCLUDE THE FOLLOWING WITH YOUR APPLICATION…all forms can be found on our web site, or will be sent via email or postal mail upon request. Please SIGN ALL DOCUMENTS THAT REQUIRE A SIGNATURE, AND BE SURE TO PLACE YOUR INITIALS IN APPROPRIATE PLACES ON ANY DOCUMENTS THAT REQUIRE INITIALS.
_____Placement Application
_____Placement Contract
_____Boarding Addendum (if the horse will not reside on property you personally own)
_____Copy of Boarding Contract (you must have one…even if you are boarding with a friend or
relative)
_____Photos of your facility…fencing, gates, water source, troughs, stall, run in shed, & other animals
on the property.
Rev120108