At-Risk Youth Equine Assisted Learning & Activities Program Application

Thanks for your interest in STAT®'s Equine programming! We offer various Equine Assisted Learning & Activity Programs, including programs for Youth living with a disability (physical, cognitive, behavioral), at risk youth (foster care, detention, sheltered, RTF, or who have exposure to substance misuse, parental incarceration), and more.

Today's Date

First & Last Name

The STAT® herd welcomes you to equine programming

STAT®’s equine-assisted learning programs for at-risk youth are sustained through the generous support of the Pennsylvania Commission on Crime and Delinquency (PCCD), the United Way of Southwestern PA, and many other funders and donors. These programs serve youth ages 5 to 24 who have experienced trauma and often struggle with emotional or behavioral challenges related to violence, neglect, human trafficking, incarcerated parents, or substance misuse within their home environments.

Referrals come through strong partnerships with social service agencies, schools, and juvenile justice systems, including County Social Services, the Children’s Bureau, Juvenile Probation, Foster Care Agencies, Group Homes, Residential Treatment Centers, Alternative Education Programs, Youth Recovery Centers, and school districts within and beyond Westmoreland County. STAT® also works directly with caseworkers, service coordinators, social workers, and families to ensure access at no cost.

All sessions are ground-based—no riding or horse experience is necessary. Youth engage in structured, goal-driven activities with horses, whose honest, non-verbal responses help participants recognize unhelpful behaviors, discover strengths, and practice positive change in real time. This hands-on approach is often short in duration but highly impactful, with results that can be both immediate and lasting.

Through our programs, participants develop and strengthen skills such as healthy coping strategies, responsibility, problem-solving, boundary-setting, communication, assertiveness, confidence, trust, respect, and relationship-building.

How Do Horses Help?

At STAT®, equines play a vital role in supporting participants—ranging from children as young as 3 to young adults up to age 24—as they navigate emotional and behavioral challenges. Through the transformative M.U.S.T.A.N.G.® program and other trauma-informed equine-assisted offerings, horses and mini-donkeys provide steady, non-judgmental companionship that keeps youth present and engaged. Their natural responses give honest, real-time feedback, helping participants recognize how their behavior, energy, and communication affect relationships.

Sessions take place in calm, supportive environments designed to spark curiosity, foster personal growth, and strengthen emotional regulation—without labels or the pressure of being “fixed.” While many programs are hosted at our Ligonier facility, STAT® also travels off-site to detention centers, residential programs, schools, and recovery settings, making services accessible to populations who may not otherwise be able to experience the benefits of equine-assisted learning.

By working alongside the animals, participants build resilience, confidence, and meaningful connections in ways that are both joyful and lasting.

Cost of Participation: There are no out-of-pocket costs for families; the only responsibility is arranging transportation to and from the barn. STAT® is deeply grateful to the Pennsylvania Commission on Crime and Delinquency for its commitment to serving at-risk youth in our community. For children referred through County agencies, established contracts cover the costs of services.

Specific Applicant Information in order to become a Participant in the STAT® PCCD funded programs.

Safety & Restrictions: programming restrictions are agreed upon with the STAT®-assigned Facilitator/Team Member, who has pre-screened applicants and determined that they are appropriate for acceptance into any one of the program.

By checking the box you acknowledge applicant has voluntarily agreed to participate and is able to safely interact with staff and horses, and recommended to the program.

Does the Applicant have any of the following:

These are the criteria required to apply for the grant based program

Please check all boxes that apply to Applicant's living situation

Are currently in foster care, out of home placement

Reside in a Group Home

Live with legal guardian(s)

Placed in Youth Detention Center

Reside in Youth Shelter

Youth Recovery Center Program

Residential Treatment Center

Other

Please check all boxes that apply to Applicant's mental health: more detail to be given below in this application

Diagnosed with mental health/behavioral challenges

Receives Mental Health therapy / Has a Mental Health Counselor

Survivor of trauma, abuse, and/or severe neglect

Have experienced homelessness

Other (Explanation)

ACES's Score (if Known)

Please check all boxes that apply to Applicant's and/or family's substance use history:

History of substance misuse

Family substance misuse history

Does not have to be recent

None/Other

Please describe, as needed:

Please check all boxes that apply to Applicant's Juvenile Record:

Does Not Apply

No Juvenile Record

Currently has a Juvenile Probation Officer (JPO) but NOT in Residential Detention Center

Past history of having a Juvenile Probation Officer (JPO)

Currently living in a Residential Detention Center

Past history of living in a Residential Detention Center

Please describe charges/criminal record of participant (past or present or if none, type "none"):

Applicant's Familiy Incarceration History:

History/Currently has a familiy member Incarcerated

Grandparent, Parent, Sibling, etc.

Does not apply

How did you hear about our equine programs?

Please Type Below

Google, School, Participated in another STAT® Program, Friend etc.

Application Form Info:

Participant (child/teen) Information

First Name

Last Name

Age

Date of birth

Ethnicity:

Hispanic or Latino

A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race

Not Hispanic or Latino

Race (Check all that apply):

White

A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American

A person having origins in any of the Black racial groups of Africa

Native Hawaiian or other Pacific Islander

A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

American Indian/Alaskan Native

A person having origins in any of the original peoples of North and South America, including Central America, and who maintains tribal affiliation or community attachment

Asian

A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam

Two or More Races

A person who identifies with more than one of the above races

School District

Zip Code

Current Grade

Do you have a second child/teen to add?

Yes No

Child/Teen First Name

Child/Teen Last Name

Age

Date of birth

School District

Current Grade

Do you have a third child/Teen to add?

Yes No

Child/Teen First Name

Child/Teen Last Name

Date of birth

Age

School District

Current Grade

Do you have a forth child/teen to add?

Yes No

Child/Teen First Name

Child/Teen Last Name

Date of birth

Age

School District

Current Grade

Do you have a fifth child/teen to add?

Yes No

Child/Teen First Name

Child/Teen Last Name

Date of birth

Age

School District

Current Grade

Do you have a sixth child/teen to add?

Yes No

Add new row

Person Filling Out This Application:

First and Last Name of Person Completing this Application

Your Street, City, State and Zip code

Preferred Phone Number for STAT to Contact

Email address

Case Worker Full Name (if same or different that who is filling out this Application):

Name of Agency

Email address of Case Worker

NOTE: Although most of our programs are ground-based, if we will be including mounted activities, we will ask in advance for medical clearance from an MD.

Medical History

Does your child (children) have any medical problems/diagnoses? (If you have more than one child: LIST the name of each child with conditions)

Yes No

If yes, please briefly describe diagnosis and any prescriptions, including allergies:

Mental Health History

Does your child (children) have any mental health diagnoses and conditions? (If you have more than one child: LIST the name of each child with conditions)

Yes No

if yes, check all that apply

anger

bipolar

depression

anxiety

post-traumatic stress

relationship conflict

substance abuse / misuse

stress

other

Is there anything else staff members need to know (i.e., safety concerns)?

Juvenile Delinquency History

Is your child currently in a Juvenile Detention facility?

Yes No

Names and Addresses of the Facility(s)

Please list charges and disposition

Does your child (children) currently have a Juvenile Probation Officer

Yes No

If yes, please list JPO name, number, and for how long

Emergency Contact Information

Is the Same Parent, Guardian, or Agency already listed also the Emergency Contact?

Yes No

First Name

Last Name

Address

Phone Number

Email address

Relationship to Child/Teen

By checking this box you agree to receive an email or phone call to set up a telephone screening interview to ensure program fit. You attest: I have read the requirements and I attest to information provided and agree for a staff member to contact me to discuss participation requirements.

By checking this box you attest your are authorized to consent for applicant, agree to to all terms, and grant permission for applicant to participate in the program.

Date

Is this equine therapy? No—this is not psychotherapy ("Therapy") or mental health treatment. STAT®’s equine-assisted learning programs are trauma-informed, skill-based, and designed to support diverse learning styles. These are growth-oriented experiences that use horse interaction as a tool for developing practical life skills. Through goal-directed, hands-on activities, participants are invited to reflect on their behavior and choices in the moment—building self-awareness, curiosity, and personal growth from the outside in.

What to expect after submitting the application:
Once your application is received, a STAT® staff member will contact the referring party—whether a guardian, case manager, or probation officer—to complete a brief screening and answer any questions. This helps us ensure a good fit between the participant and the selected program. In some cases, if needs fall outside the scope of what we offer, we may refer families to other appropriate resources. Depending on the program, guardians may also receive a link to the Theranest® Portal to create an account and electronically sign consent and waiver forms.

Participation Requirements:
To meet the requirements of our grant funding, all participants must complete a set of brief, anonymous pre-, mid- and post-program surveys (such as the ACEs, PHQ-9, AERSQ-E, and Shift & Persist tools), along with a satisfaction survey. These assessments help us improve our services, measure impact, and report program effectiveness to our funders and referral partners.

Trauma Informed Program

What does the applicant want to get out of the program or learn from horses?

STAT®’s Equine Learning and Activities Program Descriptions

Funded by the Pennsylvania Commission on Crime and Delinquency (PCCD), United Way of SWPA, and other funders/donors

STAT® provides trauma-informed, equine-assisted learning programs for youth ages 5–24, delivered at no cost through program-specific grant funding. These programs are grounded in experiential learning, social-emotional development, and skill-building, serving youth referred by schools, juvenile justice, foster care, group homes, and youth recovery centers across Southwestern Pennsylvania.

M.U.S.T.A.N.G.® — Movement. Understanding. Shifts. Trust. Adaptability. Nourishment. Growth.

This ground-based equine-assisted learning program is designed for at-risk youth, including those in juvenile detention, shelters, and foster care. Using the symbolism of the wild-to-gentled mustang, participants learn trust, courage, adaptability, and responsible decision-making through hands-on activities with horses.

EQuine Affect® — Emotional Intelligence, Mindset in Action

An interactive equine-assisted learning program that combines emotional intelligence, mindset, and growth strategies with hands-on horse activities. Offered in schools or barn settings, EQuine Affect® helps youth build empathy, self-awareness, resilience, and healthy coping skills.

H.O.P.E. — Horses Offering Powerful Encounters

A strengths-based equine-assisted program designed for youth affected by trauma, substance use, or unstable home environments. Through safe, hands-on experiences with horses, HOPE fosters resilience, emotional regulation, and a renewed sense of healing and connection.

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Our team-based approach prioritizes both emotional and physical safety at every step of the program. Trained and certified in models such as EAGALA, OK Corral, EquiLateral, and more, our staff create a supportive environment that encourages participation without pressure or perfectionism. Equine specialists also safeguard the wellbeing of both youth and horses, ensuring a safe, respectful, and positive experience for all.

Program Options: Group Class or Individual? CHOOSE ONE

M.U.S.T.A.N.G.

weekly x 12 weeks (goal: min. 4 weeks - Individual x 30 minutes (age 12-18 only)

The EQuine Affect®

weekly x 6 weeks - Individual or Group of up to 6

H.O.P.E. Horses Offering Powerful Encounters (Group or Individual)

weekly x 1 hour - Individual or Group of up to 8/group

Onsite at STAT®'s Safety Requirements:

Requirements at the STAT® Barn:

Must have transportation to and from the barn
If guardians or staff want to stay, they are to remain in vehicles in designated parking area for safety reasons.
There is not a "viewing" option. STAT® Staff members will come to your vehicle at the time of the appointment.
Wear closed toes shoes and appropriate clothing
No cell phones during programming.

STAT® Inc serves courageous people with special needs and vulnerable populations and does not accept applications for anyone with a history of violent and sexual offenses of any kind including cruelty to animals, Megan's Law, and arson.

By checking the box you acknowledge applicant is appropriate to safely interact with staff and horses, and recommended to the program and can meet the requirements to participate.

Your information will be encrypted.

At-Risk Youth Equine Assisted Learning & Activities Program Application

How Do Horses Help?

Specific Applicant Information in order to become a Participant in the STAT® PCCD funded programs.

How did you hear about our equine programs?

Application Form Info:

Participant (child/teen) Information

Person Filling Out This Application:

Medical History

Mental Health History

Juvenile Delinquency History

Emergency Contact Information

STAT®’s Equine Learning and Activities Program Descriptions

Onsite at STAT®'s Safety Requirements:

Requirements at the STAT® Barn:

STAT® Inc.