N. W. Bird Rescue & Adoption Orphanage Inc
N. W. Bird Rescue & Adoption Orphanage Inc.
13215 S.E. Mill Plain Blvd.
Suite C-8 P.M.B. # 101 VANCOUVER, WA98684
Business Office: (360) BIR-DMAN = 247-3626 Fax: (360) 260-2743 (Bird)
E- Mail;.
OrE-mail;
N.W. Bird RescueAdoption Application
HOME VISITS MAY BE REQUIRED IN ADVANCE ~
1.)Applicants name:______
2.)Applicants name:______
Address: ______
City: ______State______Zip Code ______
Mailing address: ______
Primary contact Phone # ( ) ______- ______
Best time to call ______Ask for: ______
Secondary Phone # ( ) ______- ______
Best time to call ______Ask for: ______
E-mail address ______@______
Which of the following the best describes your residence? House___ Mobile Home ___Duplex ___ Condominium ____ Apartment___
Length at current residence: Years___ Months___
Do you work more than 50 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?______
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
Have you selected a God Parent? If so please include their name in case of an emergency:
Name: ______
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 RescueAdoption 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 ______species 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 ______species Back to N.W. Bird Rescue.
I/We promise NOT to sell/trade or Breed the above-mentioned Bird/Birds, without the express written permission of N.W. Bird Rescue Inc.
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.
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 donations (Fiduciary or other wise) that have been contributed to 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: ______Date: ______
Printed name of representative: ______
Representatives Signature: ______
Title: ______
Location: ______
Time: ______Date: ______
Notes:
Office Use Only
___ Approved ApplicationDate ______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? ______
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