ECHO Partner Program Application

Executive Director/Owner Information

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone Number *

Fax Number

Email *

Confirm Email *

Organization/Farm/Program Information

Name *

Phone Number *

Fax Number

Website

Is the facility address the same as the owner's address? *

Yes

No

Is the program a non-profit? *

Yes

No

Do you have 501(c)3 status? *

Yes

No

Facility Address

Address *

City *

State *

Zip *

Facility Information

Number of Acres *

Percent of acres used as pasture *

Number of Stalls *

Average Stall Size *

Do you offer pasture board? *

Yes

No

Number of pasture boarded horses *

Number of program/lesson horses *

Number of horses currently boarding *

Total number of horses *

Does your program foster horses? *

Yes

No

On average, how many fosters do you have per year? *

Programs for which you foster *

Number of equine professionals employed *

Capacity in which your professionals are employed *

Describe arena and/or ring facilities *

Describe any current modifications that have been made to accommodate individuals with special needs. *

Program Information

What type of riding/instruction do you provide? *

Dressage

Eventing

Hunter/Jumper

Western

OtherOther

Select all that apply.

Do you provide therapeutic riding? *

Yes

No

Are your instructors certified? *

Yes

No

Please provide the names and certifications of instructors. *

Number of traditional lessons per week *

Number of horse training rides per month *

Number of therapeutic riding lessons per week *

The year(s) your program(s) were established. *

If they have evolved over time, please indicate approximate dates that programs were added.

Does your program offer riding camps? *

Yes

No

Average number of sessions per year *

Average number of campers per session *

Average cost of a camp session. *

Describe the activities or schedule during an average session. *

Do your clients participate in horse shows, events, or clinics? *

Yes

No

Please describe the activities that they participate in. *

Farrier Information

Information of the main farrier the program/farm uses.

Company Name

Farrier's First Name *

Farrier's Last Name *

Phone Number *

Email Address *

Confirm Email Address *

PLEASE NOTE: Farriers and Veterinarians may be contacted by ECHO Foundation.

Veterinary Information

Information of the main vet the barn/program uses.

Company Name

Vet's First Name *

Vet's Last Name *

Phone Number *

Email Address *

Confirm Email Address *

PLEASE NOTE: Farriers and Veterinarians may be contacted by ECHO Foundation.

ECHO Partner Program Interest

State your reasons for applying to become an ECHO Partner Program. *

Requirements

PLEASE NOTE: All programs invited to become Partner Programs will be required to:

Undergo a site visit by an ECHO Foundation Representative to be scheduled at a mutually agreeable date and time.
Provide proof of insurance.
Sign a "Memorandum of Understanding."
Sign a "Hold Harmless Agreement."

NOTE: Copies of the "Memorandum of Understanding" and "Hold Harmless Agreement" will be provided prior to the site visit.

Terms of Agreement

I/we certify that all of the information contained herein is correct and true. By signing this application, EPP applicants agree to support ECHO through offering discounts to campers supported by ECHO, support ECHO horses, and if requested, assist in fundraising efforts.

Signatures

Signature of Executive Director/Owner *

Clear

Print Name of Executive Director/Owner *

Date *

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