Heritage Farm Application Application Form All information is required unless otherwise noted (all required information must be present for the application to be approved.) If you prefer not to complete this online, you can print out the form to complete by hand and send to us at the address at the bottom of the form. Contact InformationMember Name*Primary Contact*Email Address* Phone Number*2nd Contact Name (optional)2nd Phone (optional)Farm Name*Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Farm address is same as mailing address Yes Farm Address (if different from mailing address) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Fax (optional)Website (optional) Reference InformationPlease list two references, other than family members, who can verify your farm informationReference #1*Phone*Reference #2*Phone*Farm InformationYears in Business (minimum 5 years)*Arabians at Your Facility (minimum 3 horses)*Foals Bred in the Past 3 Years*Disciplines* Recreational Trail English Western Endurance Riding Racing Youth Working Western Hunter/Jumper Halter Dressage Driving Other Services* Desert Arabians For Sale Foals For Sale Desert Arabians To Lease Stallion Services Broodmare Services Description of your farm and/or breeding program (Please include general location/mileage from the nearest major city.)*Visitor CapacityAs a HERITAGE Farm, you will receive referrals either of groups or individuals. Please select the type of group and size you are willing to accept at your farm. (Please select all that apply.)Type of Group* Any Group Families School groups of all ages 4-H, Pony Clubs, FFA Boy/Girl Scouts Other Size of Group* Less than ten 11 - 20 20+ people Please read and check the box below to confirm acceptance:As a HERITAGE Farm, I agree to accommodate visitors referred by the Institute for the Desert Arabian Horse. I will accept visitors at my discretion on a pre-arranged basis and use this program as an opportunity to share my knowledge and experience about the Desert Arabian horse. I understand that the HERITAGE FARM program was developed to provide a way for those unfamiliar with the breed to get to know the Desert Arabian horse first-hand in a non-sales environment. I acknowledge that the information above is true, and that in corresponding with referrals from the Institute for the Desert Arabian Horse, I will represent the Arabian breed in an honest, professional and courteous manner at all times. I will hold harmless, release and indemnify the Institute for the Desert Arabian Horse, its affiliates and successors, from any and all claims however they may arise relating to or concerning in any way a referral. In the event that I no longer wish to be a HERITAGE FARM, I will contact the Institute for the Desert Arabian Horse and ask to be removed from the database. I understand that my donation enrolls my farm as a recognized HERITAGE FARM and that my farm can remain in the program through ongoing annual tax-deductible contributions to the Institute for the Desert Arabian Horse. * I accept these terms Donation Payment(All information is processed over our secure servers)Please select one. If donating online, select 'Credit Card' and then click the link to visit our secure donation page in a new window.*Credit Card: I will donate through the secure online shop HERECheck: I am sending a check by mailIf sending a check by mail, please send to: Institute for the Desert Arabian Horse 2410 Sam Browning Rd. Lebanon, KY 40033 USA This iframe contains the logic required to handle AJAX powered Gravity Forms. Share this:EmailFacebook
