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Intercollegiate Athletic Activity Sign Up

Welcome and thank you for expressing interest in joining our Equine Welfare Network as an intercollegiate athletic activity. Please complete and submit the form below to sign up.

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Organization

Parent Organization/Affiliation(s) (i.e., IHSA, IDA, IEA, etc.)


Organization Type Select One Team Club Other

Street

City

*State/US Territory AEAKALAPARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVTWAWIWVWY

Zip (5-digit)

Website

Facility Name (where your programs are conducted and horses are sheltered)

Street of Facility

City of Facility

*State/US Territory of Facility AEAKALAPARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVTWAWIWVWY

Zip (5-digit) of Facility


CONTACT INFORMATION

Contact Name

Contact Phone

Contact Email

Re-Enter Email
The email address of the primary contact will serve as the login email.

1. Please select one answer below that best describes your organization's responsibility for the care of horses:
Our organization is directly responsible for the care and shelter of equines involved in our programs.
Our organization relies on other organization(s) for the care and shelter of equines involved in our programs.
Our organization is directly responsible for the care and shelter of some of the equines involved in our programs and some of the equines in our programs are cared for and sheltered by other organization(s).
The mission of our organization is equine-related, but the programs we conduct do not involve the direct use, care or or shelter of equines to fulfill our mission.

2. Has your organization ever made, or would consider making, equines available for research studies or medical training that involves invasive procedures and/or that which may cause pain or suffering to the equine? Please answer Other if equines have been or would be considered for use in research or medical training that does NOT involve invasive or painful procedures; otherwise, please answer Yes or No.    Yes Other No

2-b. If you answered YES or Other, please list ALL circumstances and explain for what purpose equines have ever been or would be considered for use in research or medical training including research or medical training that involved invasive procedures and/or that which may cause pain or suffering to the equine.


3. Has your organization ever sold, donated or given an equine to an auction or consider selling, donating, or giving an equine to an auction? Please answer Yes or No.    Yes No

3-b. If YES, describe the circumstances where you have sold, donated, or given an equine to an auction, or where you would sell, donate, or give an equine to an auction.


•  I hereby petition the EQUUS Foundation, Inc., to accept the organization named in this application as a participating organization on the Equine Welfare Network.
• I certify that I have the authority to make this petition and that the representations made in this application are, to the best of my knowledge, truthful and accurate. I further certify that I will notify the EQUUS Foundation in writing if any of the statements affirmed in this application become untrue or inaccurate.
• I certify that the organization named in this application does not engage in any activity that disregards the welfare of animals of any kind, causes an animal to feel pain or fear, exploits or harms an animal to benefit the organization, or willfully slaughters an animal to benefit the organization.
• I certify that the organization named in this application does not discriminate on the basis of race, religion, creed, national origin, disability, handicap, age, sexual orientation, marital status, veteran status or any other basis prohibited by law.

Name of Authorizer (This acts as your signature)

Job Title of Authorizer

*Enter T:4937A Here:   
The answer to the above question is required for spam control.

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