List Your Horse Submission Form

Please note check marked areas indicate YES
Name:
Address:
Telephone Number:
Email Address:
Re Enter Email Address:
Horse is located at:
Address:
Person to contact for viewings: Telephone:
 Email:

Information on Horse

 Horses NameRegistered Yes No
Reg. Name:
BreedBirth date:  Month Day Year
Height:   Colour:   Mare Gelding Stallion ColtFilly


Sire Information:
 Breed: Name:Height:
Colour:

Sires, Sire 
Breed: Name:


 Sires Dam

Breed: Name:

 Dam's Information
Breed:  Name: Height:
Colour:

Dams Sire 
Breed: Name:


Dams, Sires Dam

Breed: Name:

Listing Price Firm NegotiableBest Offer


Training Information:


Ground Work:  

Halters LeadsTiesCross TiesGround TiesStands for groomingEasy To Catch Stands for FarrierTrailersLungesClipsBaths
Understands Verbal Commands

Under Saddle

This horse is:

Not Yet Started Greenbroke (ridden less than 5 times)
Has been ridden 5-15 times Has been ridden many times and is well broke
Ridden English Ridden Western Both

Level of Rider Needed:
Beginner Advanced BeginnerIntermediateAdvanced IntermediateExperienced


Notes on the above:


Under Saddle Training:

Walks TrotsCantersGallops Lopes Smooth Gaits JumpsSide PassesNeck Reins Lead Changes Ridden with Spurs
Ridden with a CropResponds to Leg Aids Responds to hand Aids Responds to body weight aidsResponds to voice aids

Additions & Notes on the above:


Has the horse ever: Bucked Bolted Reared
Is this horse Road Safe  Traffic Safe

Has Received Training in:
Dressage Hunter Jumping Eventing Fox Hunting EnduranceTrails Competitive Trail Hunter Under Saddle Team PenningBarrels Racing Poles ReiningHarnessShowmanshipHalterRoping Lessons LeadlineShowing Pleasure Riding

Additions & Notes on the above:

Prospect For:

Dressage Hunter Jumping Eventing Fox Hunting EnduranceTrails Competitive Trail Hunter Under Saddle Team PenningBarrels Racing Poles ReiningHarnessShowmanshipHalterRoping Lessons LeadlineShowing Pleasure Riding4-H

Additions & Notes on the above:


Achievements:




 Vices:   YesNo      If Yes please list:


Health or Lameness issues past and present:

Has this horse ever suffered from:     FounderColicChoke

Does this horse or is this horse:

Live Outside Need a stallNeed Special or extra feedNeed blanketsNeed MedicationHerd BoundNeed shoes

Are you willing to disclose vet records?   Yes No

Is this horse UTD with:  Farrier Care Vaccinations Worming


In Your own words please describe your horse and ad additional information:


By completing and submitting this form you agree that if your horse is sold through NCA Equine Marketing. 
In Pre-paid agreements your horse can be listed immediately, Payments can be made via Paypal, Online Interact (www.certapay.com) or check or money order sent to
Stephanie Eddy
4374 Hwy 35 N
Cameron, ON
K0M 1G0
Prices are inclusive.  

$50.00 Horses under $4000.00      
$75.00  Horses $4000.00-$8000.00     
$125.00 (Pre-paid) Above $8000.00

I Agree

Name:  Date: