S&D Exotic Bird Rescue
APPLICATION
Name (Primary Contact): _________________________________________________
DL#/State: ______________________________________________________________
Name (Other Adult): ______________________________________________________
DL#/State: ______________________________________________________________
Name (Child): _________________________ Name (Child): ____________________
Name (Child): _________________________ Name (Child): ____________________
Physical Address: ____________________________________________
City: ____________________ State: ________________ Zip: ___________________
Mailing Address (If Different): _____________________________________________
City: ___________________ State: _______________________ Zip: ______________
Phone Number (Primary Contact #):
Home: _________________ Work: __________________ Cell: ___________________
Other Adult:
Home: _________________ Work: __________________ Cell: ____________________
Renting:
Landlords Name and Phone: ________________________________________________
Please include other rental history information for the last 2 years: __________________
________________________________________________________________________________________________________________________________________________
________________________________________________________________________
Types of Birds Owned: ____________________________________________________
Other relevant bird experience? ______________________________________________
________________________________________________________________________
Time expected to be spent with bird daily: _____________________________________
Do you travel a great deal or have annual trips or vacations you take? ____ Yes ____ No
If so, where? _____________________________________________________________
Do you have someone who is able to care for your birds if you leave on a short vacation (for four days or less?): _____ Yes _____ No
If so, has this person taken a bird care class or would be willing to? ____ Yes ____ No
References for Primary Contact Person:
Must be a parent, close relative, friend, boss, or co-worker with a permanent address who has owned the residence in which they reside for at least a year or has a positive local rental history of at least two years.
Name: __________________________________________________________________
Address: ________________________________________________________________
City: _________________________ State: _______________________ Zip: _________
Home Phone: _______________________ OTHER: _____________________________
Name: __________________________________________________________________
Address: ________________________________________________________________
City: _________________________ State: _______________________ Zip: _________
Home Phone: _______________________ OTHER: _____________________________
Donor application
S & D EXOTIC BIRD RESCUE
Donor agreement
Date______________________Birds Name____________________________
Breed_________________________________Age___________________Sex M F
Name of donor_________________________________________________________
Address______________________________________________________________
City______________________________State___________________Zip__________
Home Phone__________________________Busines Phone____________________
Reason for Donation____________________________________________________
It is hereby agreed,by and between, Donor and S & D Exotic Bird Rescue, as follows,
1. Donor is no longer able to keep/interested in keeping that bird(the Bird) as
described above.
2. Donor knows of no other person who has any claim to the bird.
3. Donor hereby relinquishes, in favor of S & D Exotic Bird Rescue, all right,
Title and interest to and in the bird, along with any cage(s),toys or other
items concurrently surrendered. This grant is immediate and absolute.
4. Donor may, at any time prior to the execution of any Bird Adoption Contract
between S & D Exotic Bird Rescue and a third party, apply to adopt the
bird, subject to the same conditions and restrictions as an adoption to a
third party.
5. It is the Donor's understanding that they are not entitled to any portion of any
adoption or any other donation.
6. It is understood that it is the purpose of this donation that S & D Exotic Bird
Rescue provide for the physical and psychological needs of the bird and Donor
may not, in any way, question or interfer with S & D Exotic Bird Rescue in
the care, treatment or placement of the bird.
I HAVE READ AND UNDERSTAND THE ABOVE AND REALIZE THAT IT CONSTITUES A
LEGAL AND BINDING CO0NTRACT.
__________________________________________________________________________
DONOR
DONATED BIRD QUESTIONAIRE
What is his basic diet?
What are his favorite foods?
What are his least like foods?
When was his last vet visit?
Any serious illnesses or injuries?
Is the bird let out of the cage? Yes No ( if no why not?)
How often? How long each time?
How does the bird exit thew cage? On his own_____On owners hand_____
On a stick_________
How do you get him back in the cage?
Is he noisy? Yes No Is he more noisy than usual at any particular time
of the day? (explain)?
What if anything seems to trigger the noise?
What successful method have you used to stop the noise?
