SurveyMethods: The easiest way to Ask, Analyze, and Improve.

LCR EQUINE PLACEMENT APPLICATION

Page

1

LCR Equine Placement Application

Page

1

of

6

*1.	How did you hear about LCR?

*2.	Name of equine from current Available List that you are interested in:

*3.	We often get multiple applications for the same equine. If the equine you are applying for is no longer available, do you want us to continue processing your application to be approved for another equine?

	Yes No

*4.	Are you currently working with or seeking out an equine from another organization? (If yes, please explain in the Comments Box.)

	Yes No Additional Comments

*5.	I understand that the equine I have chosen may not be a good match for my family, and I am open to the suggestions of LCR's counselors and trainers.

	Yes No

*6.

Please provide us with your contact information:

First Name
Last Name
Address
Address
City
US State
Zip Code
Home Phone
Work Phone
Cell Phone
Email Address

*7.	What is your place of employment?

*8.	Is it okay to contact you at work?

	Yes No

*9.	What gender do you prefer?

*10.	What age range will you consider?