Contact Us

Southeast Pennsylvania Search and Rescue 8480 Limekiln Pike, Apt. 914 Wyncote, PA 19095 Voice: 215-576-1641 Fax: 215-576-1897
ilichten1@verizon.net
sepasar@hotmail.com

HORSE EMERGENCY RESOURCE SURVEY

The information you supply on this form will be used solely to identify resources that may be called upon to assist fellow horse persons who may be in need of transportation or emergency shelter for their horses following a horse transportation accident, vehicle disablement, or similar emergency. Please complete the survey and click send.

Horse Information Survey

Email:                         

Your Name                 

Number and Street     

Township                     County

Post Office                   Zip +4  +2 

I DO   DO NOT
want to be listed as a resource at this time.

Telephone Pager

Telephone Pager
DVM : Yes No

Farrier: Yes No     Other Skills:

Stable facilities:    Yes No:

Capacity No Studs No Mares No Geldings



Trailer:     Yes   No

Capacity   Weight Capacity(lbs):

  Trailer type: Stock  Slant Side Side Entry: Ramp Step Up

Make/Model/ Color
   Plates: 



Hitch Type:

Ball  Size:   Gooseneck Size: Fifth Wheel

Brakes:

Electric Hydraulic Surge Air

Connectors

4Pin Flat 6 Pin Round 7 Pin Other 

Tow Vehicle Make:        Model:
Gross Vehicle Wt.(lbs)   Plates:  


Form, Logo, Typehead Copyright.2005 SEPASAR Contents PRIVATE PERSONNEL Data, Privacy Act 1974 as amended, release limited to official use by dispatch center personnel.