Applicant Information

First name

Last name

Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Are you an AEF member?

Yes

No

Equine Information

Number of personally owned equines in your care

Number of equines in your care that you do not own.

Are/were your personally owned equines on a property in the evacuation area?

Yes

No

Name(s), breed(s), age(s) and owner of equines involved.

Expenditure Information

Are you submitting veterinary care bills for your equine(s) as a direct result of the disaster?

Yes

No

Are you applying for reimbursement for temporary boarding?

Yes

No

Are you applying for reimbursement for emergency evacuation equine transportation?

Yes

No

Do you have other equine expenses not listed above that are directly linked to the disaster?

Yes

No

Funding Totals

Temporary boarding costs

Other equine expenses

Total amount of this funding request

Letter of Request

Letter of request

Receipts and additional information

Limit of 4 uploads. Images and documents accepted.

Applicant Declaration

I hereby attest that the information included and provided in this application is true and accurate to the best of my knowledge. I understand that a fraudulent application for the use of publicly raised funds will be subject to repercussions ranging from withdrawal of ongoing funding, repayment of funds already disbursed, or legal action taken. I understand my application and letter of request will be held in confidence as per Alberta Equestrian Federation's (AEF's) Privacy Policy.

Signature

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