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					                         Application To Adopt Birds
Your Name _____________________________________________________________________________________
Address _______________________________________________________________________________________
City/State ____________________________________________________________ Zip Code __________________
Home Phone w/area code _________________________________________________________________________
Cell Phone w/area code ___________________________________________________________________________
Work Phone w/area code __________________________________________________________________________
E-Mail Address __________________________________________________________________________________

NOTE: In order to keep our costs to a minimum, we prefer to contact applicants via email. Once an
application is approved we may sometimes need to call or write.

Number of years of experience and with what type/s of birds __________________________________________
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What type/s of birds do you own now? __________________________________________________________
______________________________________________________________________________________

What type/s of birds are you interested in? (ex: Quakers, Amazons, Conures, etc) _____________________________


Have you ever had the need to find a new home for a bird that you owned? Please explain _____________________
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Are you willing to adopt a non-handraised bird? ___________________________________________________

Are you willing to adopt a bird that has been neglected or abused? If so, are you willing to work with the bird? ______
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Do you have any experience with re-training a bird that has been abused or neglected? Explain __________________
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Are you willing to adopt a bird that has been plucking its feathers? _____________________________________

Are you willing to adopt a special needs bird? (ex: blind, lame, etc) _____________________________________

May we contact you about an available bird if it is not on your list of types of birds that you are interested in? ________
______________________________________________________________________________________

Do you own any other pets? If so, what kind/how many?_________________________________________________
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Does anyone smoke in your home? If so, please explain to what extent _________________________________
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Do you or the main person handling the bird travel for a living which would require the bird to be alone for long periods
of time? If so, who comes to care for them and interact with them? _____________________________________
Is there someone home most of the day to interact with the bird? ______________________________________

Do you allow the bird(s) to come out of the cage(s) to sit with you or on parrot stands or play gyms? Please explain.
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Will the bird be housed in a room that has little exposure to people? ____________________________________

Will the bird be housed in a room that has ample sunlight? ___________________________________________

Do you have someone to feed and care for your bird while on vacations? If so, who? ________________________
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What types of foods do you feed your birds? Do you give them fruits and veggies? _________________________
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What types of foods are toxic to birds? _________________________________________________________
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What types of household products should not be used around birds? ____________________________________
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Do you supplement your bird’s diet with vitamins? What kind? ________________________________________
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Do you have an avian veterinarian who has seen your bird(s) for routine checkups or any other reasons? ___________
Please supply the name(s) of your veterinarian(s) as well as their address(es). ________________________________
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Please provide one character reference from either a pastor/minister, authority figure such as an employer/physician,
or a very close personal friend. (We would need a name, what their relationship is to you, and an email address or
physical address so that we may send them a reference form to fill out)
__________________________________
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_______________
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_______________
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Please provide any other useful information that would help find a suitable bird for you. _________________________
______________________________________________________________________________________
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How far are you willing to travel in order to pick up a bird once adoption is approved? Please explain in distance
(miles) or in amount of time (hours). (Some are willing to travel by car for two days in order to pick up a bird, please
state exactly what your limitations are) _______________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________


Please send application to:                Bird Lovers Only Rescue Service
                                           c/o Irena Schulz
                                           1448 Tanglewood Drive
                                           Schererville, IN 46375
Or email completed application to:         birdloversonly@sbcglobal.net

				
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