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Bird Rescue Adoption Application Form

Collects an applicant's household details and experience to help staff decide whether their home is a good match for a rescued bird.

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Full Name

First Name

Last Name

Address

Street Address

City

State / Province

ZIP / Postal Code

Phone Number

Number of Adults

Number of Children

Ages of Children (if applicable)

Type of Residence

House Apartment Condo Other

Do you own or rent your home?

Own Rent

Landlord's Name

First Name

Last Name

Landlord's Phone Number

What type of bird are you interested in adopting?

Why do you want to adopt a bird?

Have you owned birds before? If yes, please provide details.

How much time can you commit to interacting with and caring for a bird each day?

Are you aware of the financial responsibilities associated with bird ownership, including food, veterinary care, and supplies?

Yes No

Describe the living environment where the bird will be kept.

Is anyone in your household allergic to birds?

Yes No

Veterinarian's Name

First Name

Last Name

Veterinarian's Phone Number

Personal Reference

First Name

Last Name

Reference's Phone Number

Additional Comments

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