Personal Reference

Your personal reference may not be an immediate family member and it also may not be the same person who fills out any other reference form(s) for you.

To be completed by adopter/foster applicant:

___________________________________________________
Name

___________________________________________________
Address

___________________________________________________
Phone 

To be completed by reference:

___________________________________________________
Name

___________________________________________________
Address

___________________________________________________
Phone 

How long have you know the applicant? __________________

Describe your impression of the care and condition of the animals the applicant currently owns:


Do you think the applicant would make a good foster or adoptive home for an equine from Indiana Horse Rescue?

Why or why not?


Signature 

Date

Thank you for taking the time to complete this form!

Return to:

Indiana Horse Rescue East
PO Box 101
Farmland, IN 47340

Phone 765-468-6104
Fax (206) 338-5604