SAFER Horse

SAFER: Sonoma Action For Equine Rescue
Hay Assistance Program Application
Please use back of sheet if more room is needed.

Name_______________________________ Phone(s)__________________________________

Address________________________________Email ___________________________________________

Horses involved

Name Age Sex (Mare/Gelding or Stallion) Color/Markings Teeth Deworming

___________________________________________________________________________________________________

Are other horses kept on premises that will not need SAFER Feed? If Yes how many_____________
Address where horses are kept if different from above: ______________________________________________________________

Caretaker’s Name (if different from owner) ___________________________

Caretaker’s Phone(s) _____________________________________

Approx. how long will donated feed be needed – and how determined ____________________________________________

______________________________________________________________________________________________________

Estimate of feed needs daily; include pellets and other supplemental feeds:

______________________________________________________________________________________________________

______________________________________________________________________________________________________
Financial information:

Please describe your situation, including reasons for the unanticipated shortage and timelines for resolution: ______________________________________________________________________________________________________

______________________________________________________________________________________________________

Please enclose documentation - for example: Checking account statement/ Savings account statement – (please black out the account numbers.) Statement from unemployment office or disability statements or Stubs from SSI or STD payments.

Corroborating reference name and phone number (case worker; banking contact etc.)

______________________________________________________________________________

Email to [email protected]

Mail to:
SAFER
9825 Mill Station Rd
Sebastopol CA 95472
707-824-9543
Guidelines for Hay Assistance

No Breeding program of any kind in place for a minimum of 5 years.
Documentation MUST be complete as requested.
Situation must be short term - SAFER will also assist in rehoming horses if that is the best solution.
SAFER has the SOLE RIGHT TO DETERMINE ELEGIBILITY.

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