1) Name: 2) Address: City State Zip Code. How did you hear about us?: Primary contact Phone # ( 2 nd contact Phone # ( ) -

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Asher Hart
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1 Northwest Bird Rescue s Adoption Application Home visits will be required in advance *Please review our Adoption Policies attached below before filling out this application. 1) Name: 2) Address: City State Zip Code How did you hear about us?: Primary contact Phone # ( ) - 2 nd contact Phone # ( ) - Which of the following the best describes your residence? House /Mobile Home /Duplex /Condo /Apartment Length at current residence: Years Months Do you work more than 40 hours a week? Yes No Do you have children? If so what ages? Do you currently have any birds? If so what Type: Do you have any other types of pets? (If so what type, species age) What type of bird are you applying for? What are you looking for in a Parrot? (Talker/ Mimicker/ Cuddlier ) Do you currently have an avian veterinarian? How much time can you allow your new bird to play out of the cage? I/ We understand adoption of a bird is a life long commitment: I/We understand that we cannot: Breed/Trade or sell this adopted birr and N.W. Bird Rescue holds first right of rescission. (Return the Bird Back to N.W. Bird Rescue). If I/ we cannot provide a God Parent for our newly adopted bird in case s of emergency. *We promise to return this bird back to N.W. Bird Rescue. 1

2 Northwest Bird Rescue s Adoption Application Have you selected a God Parent? Y/N *We require that All Godparents live in a separate household in case of fire at you home or other emergencies that would force you to evacuate your home. * If you have a designated Godparent, please include their name in case of an emergency: Name of God Parent: Address: City: State: Zip Code: Contact Phone number ( ) - *If we can not provide a God Parent we promise to relinquish this bird back to N.W. Bird Rescue. N.W. Bird Rescue Adoption Application HOME VISITS MAY BE REQUIRED IN ADVANCE ~ In Addition: I/ we promise to provide a safe haven for our newly adopted bird. We promise a loving nourishing home, with a proper diet of fruits and vegetables. We also promise to provide this bird with medical care for this bird if needed. We also promise that we will never breed, sell or trade this newly adopted parrot. If for any reason we can no longer care for this parrot, we promise to return it back to N.W. Bird Rescue. I/We promise to love honor and cherish our newly adopted bird for life. If I/We cannot, I/We promise to return our adopted orphaned Bird named: aka: an apparent Year old (Female / Male) of breed Back to N.W. Bird Rescue. I/We promise that we will NOT to sell/trade or Breed the above-mentioned Bird/ Birds, without the express written permission of N.W. Bird Rescue Inc. *(Which we understand that will never happen) I/We also understand that N.W. Bird Rescue may conduct up to three surprise home visits within the next 2 years of adoption. *Hours of surprise visits are to be within the hours of AM 9 PM Monday thru Sunday 7 days a week including minor holidays. 2

3 Northwest Bird Rescue s Adoption Application Surprise Visit Disclaimer If any member/volunteer or Officer of N.W. Bird Rescue deems this Parrot or parrots are neglected, in danger or in poor condition. I/We promise to immediately surrender this parrot and all adopted parrot belongings, including cage and all toys, are to be given back to N.W. Bird Rescue immediately, to the representative of the Orphanage. I/We also understand that any and all donated items with this parrot; (Fiduciary or otherwise, cage s, perches, toys etc.) that have been contributed by N.W. Bird Rescue will be forfeited. * We currently do not have an approved Godparent for N.W. Bird Rescue. So we promise to will these two birds back to N.W. Bird Rescue incase of any emergency. By signing this agreement we agree to the terms above: Adoptive Parent #1: Date: Adoptive Parent #2: Printed name of representative: Representatives Signature: Title: Location: Time: Date: Office Use Only Approved Application Date Denied Application Date Reason for approval/denial: Breed of parrot applicant is approved for: Home visit occurred Date: Notes: Information to be given to applicant: Diet Bathing Housing Grooming Quarantine Introduction period Physical disabilities/limitations of bird Medicating Adoption Date: Donation given? 3

4 Northwest Bird Rescues Adoption Policies *Please understand that many of the birds that placed with us were possibly neglected or abuse. They will need tender loving care. For this reason we require the following requirements. Applicants should be aware the following Requirements Pre-Qualifications for Adoption: You must live within a 40 mile radius of our zip code (No exceptions) You must be willing to allow us to conduct home visits prior to being introduced to any available parrot for adoption. (No exceptions) You must own your own reliable transportation. You must have some type of income. You must be able to afford your own adoption fee. We will not place a bird to a 2 nd or 3 rd Party. Reside in your present residence for a minimum of four months. *(If asked you may need to provide proof by showing utilities bills in your name) Also, please be aware that we will never place any bird with any home that houses any breed or mix breed of Terrier dog or dachshund dogs. These two breeds have an instinctive gene that will make them eventually kill parrots. There s over a decade of documented proof of bird tragedies. Because of this proven fact we will not place any bird with any home that houses theses breeds. (Sorry) We prefer that all adopters be the minimum age of 30 years of age, and of stable income. 4

5 The Primary adopter must work under forty two hours a week. We won t be able to place a bird in any household that currently has over six indoor pets. Parrots need a nourishing environment with a regular routine of attention. We will conduct one interview at a time, deciding on each person and or family or situation will be the ideal home for all adoptable birds. Please be advised that some birds have a background were they have special needs or fears of certain animals or humans. In this situation, we will only place a bird within the needs of the bird first. We also recommend you select a God Parent prior to committing to adopt our available parrot. We recommended that your Godparent reside at a different home. (In case of a fire emergency) If you do not have a God Parent for your newly adoptive bird we require you sign an agreement that we are grandfathered in as the God parent for your new bird in case of any emergency. We also recommend that you introduce your new bird to you bird sitter 30 days before any vacation. In addition, the sitter should handle and inter act with your new parrot for a total of at least 30 minutes. (We recommend two visits before you leave on a trip). We will expect you to be honest about your budget. If you decide that you want to adopt a Parrot in need of a new stable home. Please be truthful with us. If you can afford the care and veterinarian care required for any parrot in the case of an emergency, then please don t apply... *We are happy to work with some low income situations, for some of our smaller orphaned parrots. ; It is highly unlikely that we will place any bird with anyone who currently owns any breed of Terrier dog or Dachshund dog. (These breeds have a poor history of being friendly to parrots) In addition; It is unlikely that we will place a second chance parrot in a home that currently house s more than four parrots, and or more than three children under the age of sixteen. 5

6 We do not place our exotic birds to any animal breeders, pet stores, or individuals that sell domestic animals. We will not place a bird to a business that wants the bird as a store mascot. We will not supply mutable or mass pictures or videos of adoptable parrots prior to adoption. We are looking for permanent placements for our adoptable birds that can ensure a lifelong home adoption. So, please also understand that adoption fees are nonrefundable. All adopted birds are expected to be kept in the same care as when they leave us, if not better care. Surprise Home visits do occur. If we find our placed parrot in unsuitable conditions we will take the bird back. (Escorted by law enforcement if necessary) We take our placements very seriously. *All adopters must sign this agreement before placement. No exceptions. *(This is of course depends on the birds background) we would like to meet the children before placement. In addition, we understand the special needs of most of our second chance birds. They will need a routine household, with a calm environment. This will help them acclimate to their new home with minimal future behavioral problems. *We discourage or rather would not place a second chance bird in a high traffic home that has any children under the age of 16. *Thank you for reviewing our adoption policies in advance of filling out our adoption application. If you strongly feel that you can offer one of our parrots a good home under these restrictions, then please fill out our adoption application and send it to us as soon as you can. 6

Bird s Name Species. Owner s Name. Address. City State Zip Code. Home Phone Work Phone. Fax

Bird s Name Species. Owner s Name. Address. City State Zip Code. Home Phone Work Phone. Fax Parrots First 13063 Gladstone Ave Sylmar, CA 91342 (866) 712-8899 http://www.parrotsfirst.org Bird Acquisition Form Thank you for taking the time to complete this acquisition form in its entirety. The