Applicant InformationName First Last Date of Birth PhoneAddress Address City State / Province / Region ZIP / Postal Code OwnRentAddress where calf will be housed Street Address City State / Province / Region ZIP / Postal Code OwnedRentedZoning:Veterinary Care InformationVeterinarian Name:Veterinarian Address:Veterinarian phone:E-mail:Fax:NeighborsNext Door Neighbor Name:Next Door Neighbor Phone:Are neighbors aware that you will have a cow on the premises?Farrier InformationName:Phone:Address Current Address City State / Province / Region ZIP / Postal Code ReferencesName: (Different than Neighbor)Address:Phone:Signature of applicant: (check the box below) Digital Signature Date:Signature of applicant: (check the box below) Digital Signature Date:Questions:1. Cow will be kept in (please check 1) A field with no shelter or only trees In a barn In a small corral with run-in shed In a field with a run-in shed Other; Please describe in full detail below Describe2. Describe the cow facility you already have in place. Do you anticipate any changes in the near future?3. Acreage of paddock or pasture:4. Type of fencing:5. Do you have other cows or horses in the pasture your new adopted cow will be living in? Please elaborate:6. Have you owned cows previously? If so, where are they now? Sold to auction Paid slaughterhouse and put cow in freezer Slaughtered cow personally in backyard Shot cow Euthanized cow 7. Why do you want to adopt a companion cow?8. Do you eat beef and if so, why?9. Why do you think you can provide a happy and meaningful life for a cow whose life expectancy is 20-30 years?10. If your adopted cow doesn’t work out you will: Sell him at the most profitable livestock auction Put up an ad on Craigslist Call a livestock dealer and ask him to pickup your cow Try to place the cow locally Call My Speckled Calf Rescue Immediately and make arrangements to return the cow 11. What food do you intend to feed your new rescue cow? Field grass only Field grass and supplemental hay Hay and grain Grain or silage only 12. If you are feeding hay, please describe what kind.13. Hay Dealer or Feed Store name and phone #:14. Do you participate in the rodeo?15. Will your rescue cow be utilized for any purpose?16. Do you anticipate hauling your cow with you if you move?17. Do you believe that other cows should be raised for beef and slaughtered? Please explain why this cow is different.18. Have you ever participated in either a beef or dairy cow share?YesNo This iframe contains the logic required to handle Ajax powered Gravity Forms.