Placement (Adoption) Application

Today's Date

MM

DD

YYYY

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Living Situation *

Own

Rent

House

Condo

Apartment

Employment

Full-time

Part-time

At Home

Extended Travel

Retired

Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Would you be willing to volunteer at Foster Parrots? *

Yes

No

Would you be willing to let a Foster Parrots representative conduct a pre-adoption home visit? *

Yes

No

Would you be willing to let a Foster Parrots Representative conduct post-adoption home visits *

Yes

No

Would you be willing to provide temporary foster care to a parrot? *

Yes

No

Would you be willing to adopt a noisy parrot? *

Yes

No

I'm Not Sure

Would you be willing to adopt a wild or untamed parrot? *

Yes

No

I'm Not Sure

Would you be willing to adopt a bonded pair of birds? *

Yes

No

I'm Not Sure

Would you be willing to attend up to 3 parrot care classes at Foster Parrots? *

Yes

No

If you parrot becomes ill or injured, are you financially capable of addressing the cost of specialty veterinary care? *

Yes

No

Veterinarian Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Veterinarian Phone

(###)

###

####

Are you aware of the dangers of using non-stick cookware in the presence of birds? *

Yes

No

Do you currently have non-stick cookware in your home? *

Yes

No

If Yes, are you willing to replace all non-stick cookware products?

Yes

No

Do you or does anyone else smoke inside the home?

Yes

No

Do you plan to clip your bird's wings? *

Yes

No

Are you aware of the physical and psychological health benefits of flight? *

Yes

No

Are you aware of the potentially long life-span of parrots? *

Yes

No