Adoption Order Form

           

Registered Chincoteague Ponies For Adoption:
___ Crackerjack of Assateague,(copperStallion)                         ___ Miss Arrow HeadNine(tri-colored pinto Mare)
___ IceCreamSundae(tri-pinto Mare)                                          ___ B.G.Black Gold Stallion(jet solid black) 
___ Miss Ginger of Assateague(solid sorrel Mare)            
         ___ SeaFoam(solid white with bay medicine hat, stallion)
___ Black Diamond(solid Black with a white diamond on her forehead, Mare)     ___ foals.
 .
Please check your choice.


Annual Adoption Fee: $50 Donation (By check or PayPal using GFreder426@aol.com
)
Includes: Color photo, personalized adoption certificate, fact sheet about your pony and additional Chincoteague Pony Farm information.

NAME:
__________________________________
ADDRESS:
_______________________________
CITY:
______________ STATE:__________ ZIP:__________  Country____________
Country Code______________________
PHONE:
______________________
EMAIL:_______________________


Gift Recipient (if gift):

NAME: ______________________________________
ADDRESS: __________________________________
CITY: _________________STATE: _______ZIP:��_______
COUNTRY ______________COUNTRY CODE__________
PHONE:_________________________
EMAIL:________________________

GIFT MESSAGE (optional): ________________________________________________________________________________ ________________________________________________________________________________

Please print off form and fill out.
Please mail your remittance and the above form to:

The National Chincoteague Pony Association
2595 Jensen Road, Bellingham, WA 98226


360-671-8338 voice mail
360-671-7603 fax

www.pony-chincoteague.com
www.pony-chincoteague.org   
A non-profit Organization

 

Black Diamond

 

B.G. BlackGold Stallion

 

 

 

Crackerjack Stallion

 

Foals

 

 

 

Miss ArrowHead Nine Mare

 

SeaFoam Stallion

 

 

 

IceCreamSundae Mare

 

Ginger of Assateague Mare