Washington Stallion Support
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Haul-In Gelding Clinics
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Gelding Assistance Application
Owner Information
Applicant Name
*
First
Last
[object Object]
Applicant Name
*
First
Last
[object Object]
Organization (if applicable)
*
If you are applying on behalf of an equine rescue or organization, please provide their name here.
Phone
*
Alternate Phone
*
Email
*
Address
*
City
*
State
*
Zip Code
*
County
*
How did you hear about us?
*
Equine Information
Choose One
*
Horse/Draft
Miniature Horse/Pony
Mule
Donkey (Standard or Miniature)
Are they a Cryptorchid?
*
Yes
No
Not sure
Name
*
Age
*
Breed
*
Color/Markings
*
How did you acquire them (check all that apply)
*
Private Sale
Rescue
Auction
Feed lot or Kill pen
Free to $500
Owned since birth
Purchased from breeder
Intentional breeding
Unintentional breeding
Advertised on Craigslist
Advertised on Facebook
Other
If other, please specify:
*
Height
*
Weight
*
How long have you owned them?
*
City and County where animal resides:
*
If you are applying for assistance for more than one animal, please make a note of that in the comment box below, and we will contact you for their information.
Veterinary Information
Veterinarian's Name
*
Veterinary Practice
*
Phone
*
Email
*
Website
*
Has this vet examined them before?
*
Yes
No
Financial Information
What price has the vet quoted you for the procedure?
*
What amount will you personally contribute to the cost of the procedure?
*
Are you applying for assistance through any other organization? If so, which one?
*
Total amount of assistance requested from Washington Stallion Support:
*
Please explain why you are applying for assistance.
*
Other
How soon would you like to schedule the procedure?
*
Immediately
Within 1 month
Within 3 months
Within 6 months
Over 6 months from now
Do you own any other intact equines that you don't plan to geld at this time?
*
Yes
No
If yes, please explain:
*
Have you bred any mares or stallions within the past 10 years?
*
Yes
No
If yes, please explain:
*
Is there any thing else you would like us to know?
*
By submitting this application you are representing that the information provided is accurate and that you are the legal owner and/or have the authority to make veterinary decisions for this animal.
The information provided by applicants is kept confidential and is for internal review and use only. For requests that are approved, we will publish only the horses name, city/county, and amount for fundraising purposes.
Please note that if you run a breeding operation for profit, your application will likely be denied.
Submit
Home
About
Programs
MEET THE HORSES
Haul-In Gelding Clinics
Gelding Assistance Application
Outreach
NEWS
OUR SUPPORTERS
How to Help
Volunteer Application
Wish List
Contact Us