Adoption Application
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your occupation?
*
Do you rent or own?
*
Rent
Own
Other
If you rent, do you have permission to own birds?
*
Yes
No
N/A
Number of people in home?
*
Are there children in the home? *If yes, list ages*
*
Any household allergies to birds?
*
Is everyone in the household supportive of this adoption?
*
Do you currently have any pets?
*
If yes, (list their species and how long you've had them)
*
Have you owned birds before?
*
If yes, what species and what happened to them?
*
What species are you interested in adopting?
*
Do you have experience with this species?
*
What qualities are you looking for in a bird?
*
Are yo open to adopting a bird with behavioral or special needs?
*
Yes
No
Maybe
Describe your daily routine with a bird in your home.
*
How many hours per day will the bird be alone?
*
Where will the cage be located?
*
Describe the birds planned diet and enrichment.
*
Are you aware that some birds live to be 20-80+ years old?
*
What plans do you have for your bird if something happens to you?
*
Do you have an avian vet? If so, provide clinic name.
*
Personal Reference (Name, Phone number and Relation)
*
I certify that the information I have provided is true and accurate to the best of my knowledge. I understand that submitting this application does not guarantee adoption.I agree that any bird adopted from Wild Ones Avian Rescue, Inc. may not be bred, sold, or transferred to another person or organization. If I am no longer able to provide proper care, the bird must be returned to Wild Ones Avian Rescue, Inc. and may not be surrendered, sold, or rehomed elsewhere without prior approval from the rescue.By submitting this application, I acknowledge and agree to these requirements.
*
I Agree
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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