* Required Fields
Name of Organization:	*
Mailing Address
Address 1:	*
Address 2:
City:	*
State or Province:	Please select Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon *     Zip Code *
Phone Number:	*
Contact Name:	*
Email:	*
Title:
Web Site:
Physical Address Same as Mailing Address
Address 1:	*
Address 2:
City:	*
State or Province:	Please select Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon *     Zip Code *
Year Established:	IRS 501(c)(3) Tax Exempt (YES)
Year Determination Issued:	Federal Tax ID:
Does your organization follow the AAEP Euthanasia Guidelines?
Yes: -- No: -- Yes (with exceptions):
Please List exceptions:
Type of Organization — Select all that apply:
Retirement/Sanctuary Adoption Broker Foster Home College/University Federal or State Government Police Department/Correctional Rescue Group Retraining Facility Riding Stable Therapeutic Riding Other
	How many total horses (all breeds) does your organization currently have in its care?
	How many Thoroughbreds does your organization currently have in its care?
	How many personal use (owned or boarded) horses (all breeds) does your organization care for are kept at the facility?
What are the main sources (racetrack, auction, etc.) of the Thoroughbreds in your care?
Please answer the following
# Full time staff      # Part time staff # Volunteers
Please describe your organization (max 250 words)
Does your organization provide re-training (ground work and under-saddle) for Thoroughbreds?      Yes: No:
Does your organization require a donation/fee when it accepts a Thoroughbred?                                   Yes: No:
Does your organization require a donation/fee when it re-homes a Thoroughbred?                                 Yes: No:
Please provide contact information for your organization's primary veterinarian.
Please complete the following information for all facilities your organization uses to house Thoroughbreds:
# Name of Facility Location Size of Facility (Acres) #Thoroughbreds 1   2   3   4   5   Click button if you need to add more locations -