Grant Assistance Application Form

This application is for Canadian nonprofit organizations only.

Grants are awarded for equines only, defined as: horses, donkeys, mules, hinnies, ponies, zebras, zebroids.

If you are requesting assistance for multiple equines, please complete a separate application for each one.

If the equine does not have name yet, then in the name section list as how you have registered the animal in your organization.

Three photos of the equine benefiting from the grant (one of each side and one of their face) will be required.

Which grant are you applying for?

Name of Organization

CRA Registration Number

Physical address of facility (not mailing address if different)

Name of Contact Person

Phone

Year your organization was founded

Number of equines at your facility

Your website

Your social media links

Tell us why you need assistance

Equine's Name (If the equine does not have name yet, then list as how you have registered the animal in your organization.)

Breed

Colour

Age

Sex

When was this equine admitted to your organization?

Does this equine have any health or behavioural problems?

Are veterinarian records available?

Photos of the Equine (3 total - one of each side and one of the face)

Approximate Date of Procedure

Name of Veterinarian Office/Clinic

Name of veterinarian who will perform the procedure

Mailing Address of Veterinarian Office/Clinic

Phone Number of Veterinarian Office/Clinic

Email Address of Veterinarian Office/Clinic

Authorization and Release: I agree to provide pictures, videos, invoices and other documentation, as needed, to satisfy terms of receiving a grant from Horse Aid Canada.

Health Records Release: I authorize the release of any available health records for the animal which the grant is to benefit.

Acknowledgement: I agree to acknowledge the grant from Horse Aid Canada on all our social media platforms thereby raising awareness of their grant programs with the goal of helping more equines.

Media Release: I agree to allow Horse Aid Canada to use photos, videos and information about the equine(s) for which I am receiving a grant at their discretion for the purpose of raising awareness of their grant programs with the goal of helping more equines.

Signature

Date signed