Avian Placement Application

The first step in the adoption process is to tell us a little about yourself. If you have attended one of our Beak Speak meetings then you have an idea of what is involved in living with a parrot or cockatoo. Fill in the answers as best you can. Don't worry. If you need to learn more about these magnificent creatures our Beak Speak meetings will help!

Filling out this form doesn't guarantee that you will be able to adopt a bird but it gets your foot in the door!

* First Name

* Last Name

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

* Mobile Phone Number

* Email Address

* Type of residence:

House

Condominium

Apartment

Other

* Do you

Rent

Own

* If you rent, do you have the landlord's consent to have a bird?

Yes

No

Does not apply - I own my home

* Do all parties in your household know that you are applying to adopt a bird?

Yes

No

* Are you aware that exotic birds may carry diseases that can infect humans?

Yes

No

* Does anyone in the household harre allergies or asthma?

Yes

No

* Does anyone in the household smoke?

Yes

No

* Who will be the primary caregiver for the bird?

* Who will care for the bird when the primary caregiver is away, either for business or vacation?

* Approximately how much time will the responsible person have available to spend with the bird on weekdays?

* Approximately how much time will the responsible person have available to spend with the bird on weekday evenings?

* Approximately how much time will the responsible person have available to spend with the bird on weekends?

* How many hours a day willthe bird be left alone?

* How will you provide daily exercise and entertainment for your bird?

* Why are you interested in adopting a bird?

* What are the most important characteristics you are looking for in a bird?

* What do you feed an exotic bird?

* Do you have any experience in keeping birds?

Yes

No

* lf so, please describe.

* Would you be willing to attend a class on bird care if available?

Yes

No

* Do you know an avian veterinanan?

Yes

No

* Would you like us to recommend an avian veterinarian?

Yes

No

* Are you aware that exotic birds might have or develop bad habits (destruction of clothing, furniture, drapery, etc; biting; screaming; dislike of strangers or certain household members; leaving droppings everywhere), and that these habits can be difficult to modify?

Yes

No

* lf your bird develops a bad habit, what will you do?

* Will you make arrangements for your bird(s) in the event of your illness or death?

Yes

No

* I have completed the above application and have read the provided information, I understand that a staff member will review my application and that The Chloe Sanctuary for Parrots and Cockatoos has a right to refuse adoption to any applicant.

I am aware that before any adoption can proceed a home visitation will be required. I am also aware that if approved, I must supply a proper cage for the bird.

ALL ADOPTION DONATIONS MUST BE EITHER MADE THROUGH OUR WEBSITE OR BY CHECK. CHECKS MUST BE MADE OUT TO THE CHLOE SANCTUARY. NO CASH WILL BE ACCEPTED FOR ADOPTION DONATIONS, AND NO CHECKS MADE OUT TO ANY OTHER NAME, NO EXCEPTIONS.

Filling out this form does not guarantee that I will be able to adopt a bird.

Please enter your full name in the space provided as your digital signature.

* Indicates Response Required