Please copy and paste application into a word document or Email body. You may email us to request it in word format or rtf
(mac users) if you have difficulties. Please be sure to include the application fee when you mail in your application, or use
paypal to submit it online. Application fees are used for general operation of the rescue.
Pampered Parrots Avian Rescue
Adoption Application
PO Box 1644 Airway Heights, WA 99001 Please Be encouraged to call with any questions (509) 218-3438
• All Fields Required to Avoid Immediate Ineligibility
Filling out an Application does NOT guarantee eligibility to adopt
Date________/_________/_________
Name:_______________________________________________ Age:_______________
First, Middle, Last
Previous names you have gone by:_____________________________________________
Circle One: Single Married Widowed Divorced
Spouse:_____________________________________________ Age:________________
Physical Address:_______________________________________________________________
City:______________________ State:____________ Zip:____________
Mailing Address: N/A or: _______________________________________________________
City:______________________ State:____________ Zip:____________
Please list any other states you have lived in the past 5 years:___________________________________________
__________________________________________________________________________________________
Phone:(______) ___________________ Cell/Pager_____________________ Message____________________
E-mail:_________________________________________________________
Drivers License # ____________________________ State:_______________
Children living with you: Yes_______ No________ Ages:_____________________________
List names of any other adults living with you:_____________________________________________________
Other pets or animals: Yes No Kinds:
Have you ever had an animal taken from you by the ASPCA, Humane Society, or other animal protection service? Yes
No If yes, why?
Living Situation: Own Rent House Apartment
Landlord:______________________________ Phone:(________) ____________________
Does your rental allow birds? Yes No
Smoker? Yes No Indoor Outdoor Specific room Other
Do you agree to not smoke inside if you adopt? Yes No
(Due to dangers to an avians respiratory system, answering no is an immediate disqualifier. Any evidence of smoking in
the home after adoption will result in immediate repossession of the bird.)
How did you hear about Pampered Parrots, and whom should we thank if it was a person or other organization?
Please give us detailed instructions as to how to get to your home using starting points of well known intersections e.g. I-
90/Division, Sprague/Pines. Use as many details as possible while using as many road names/crossroads as you can.
Don’t forget to describe your house/yard with color, trim or other specifics to help point it out. Attach additional sheets as
needed.
Employment: Full time__ Part time__ At home__ Student__
Job Title:_________________________________________________________
Employer:________________________________________________________
Employer address:_________________________________________________
Employer phone: __________________________________________________
Spouse Employment: Full time__ Part time__ At home__ Student__
Job Title:_________________________________________________________
Employer:________________________________________________________
Employer address:_________________________________________________
Employer phone: __________________________________________________
Household Income: Monthly gross or yearly gross (before taxes) (needed only for decision as to whether you are
financially capable of caring for parrots – food, vet care, toys, etc, Information is never shared or sold to anyone)
References – Three – May not be someone related to you or any member in your household:
________________________________ ________________________
Name Phone
How long known? _________________
________________________________ ________________________
Name Phone
How long known? _________________
________________________________ ________________________
Name Phone
How long known? _________________
Do all adults in the house know you are applying to adopt a bird? Yes No
Does anyone in your household object to your adopting a bird? Yes No
If yes, please explain:
Is there anything you would like to add or share with us?
Would you like to volunteer to staff or be part of a committee for PPAR special events such as parades, Petfest,
Bragfest, school visits and more? Yes No
1. Do you agree to a representative of PPAR visiting you in your home before Yes No
and after adoption?
2. Will you agree to take a minimum one-hour parrot education course? Yes No
3. Are you willing to take in a special needs bird? Yes No
4. Are you willing to adopt a wild, noisy, or non-hand tamed bird? Yes No
5. Are you willing to take in a pair of birds and not separate them if they are Yes No
bonded?
6. Adopting a bird for breeding purposes is not allowed. Do you agree to not Yes No
breed?
7. Would you be interested in being a Foster Parent? Yes No
8. Do you agree to not sell the bird* and return it to the rescue in the event
You can no longer care for it? Yes No
9. Do you agree to not use the bird for any kind of scientific or laboratory
testing or experiments?* Yes No
10. Would you be willing to work a minimum of 1-5 hours volunteer service Yes No
as another part of the adoption donation? (not mandatory)
11. Do you have any type of disability that may keep you from changing/ Yes No
cleaning the cage/liner or keeping food/water bowls clean?**
12. Do you have any type of disability that may keep you from feeding or Yes No
watering a bird, or giving fresh water?**
13. Do you have any type of disability that may keep you from being able to Yes No
Recover a bird from high, low, or behind places?**
14. If you answered yes to any questions 11-13, please explain disability here and if you have someone to help you
accomplish above tasks (e.g. Mother, father, caregiver, nurse) Use additional sheets as needed.
*answering no to these questions automatically disqualifies you. These questions are part of the adoption clause.
**answering yes does not disqualify you; it only aids us in matching you with the correct bird.
15.In case of emergency, do you have someone lined up that is fully capable to care for your bird(s) with little to no
notice? Yes No
If yes, may we contact them? Name & Number:____________________________________
16. Who will be the primary caregiver for the bird? __________________________________
17. Where would the bird be located in your house? ________________________________
18. Where would the bird sleep? ________________________________________________
19. Will there be children participating in the care for the bird? Yes No
20. Will they be supervised? Yes No
21. How many hors a day will the bird be left alone? ________________________________
22. How many hours a day on the weekend? _____________________________________
23. How many hours a day will the primary caregiver be gone on weekdays? ____________
24. If your present relationship should change, who would keep the bird? ________________
25. Parrots can be destructive, bite, scream, hate strangers, your mate & kids, and leave feces all over. Are you
prepared to accept these things happening in your home? Yes No
26. If your adopted parrot develops a bad habit how will you deal with it and what will you do?
27. what would need to happen for you to decide you are unable to keep the parrot you have adopted? Moving___
Divorce/Separation___ New Baby___ New Job___ Allergies___Current Pet interaction disputes___ New relationship___
Serious illness/terminal illness___Prefers one person in the family only ___ Biting ___ Screaming ___Too Noisy ___ Cannot
Spend enough time with the bird ___ The bird doesn’t talk ___ The bird does not perform ___
Complaints from neighbors ___ Expenses become too much ___ Other _________________
___________________________________________________________________________
28. Please tell us why you would be a good candidate for parrot adoption and if you have had any past pet bird experience.
Please include any past ownership, how long you owned them, and if you no longer own them please explain why not. Be as
thorough as you can. Attach additional sheets as needed.
29.What type of bird(s) would you be interested in adopting? Please name species, size, age, noise level, or anything else that
may help us find the perfect match. Attach additional sheets as needed.
30. Do you currently have an Avian Certified Vet or a qualified Vet with a special interest in
Avians? Yes No
31. If yes, may we have permission to contact your vet for references?
Name & number of vet:_________________________________________________________
32. If you do not have a vet, may we suggest one to you? Yes No
Be sure to initial and sign Contract Inclusions found HERE
Also read and sign 10 things you need to know before adopting a bird: HERE
If at any time during the life of the parrot, if the adopting person(s) no longer wishes to keep the parrot, the parrot must be
returned to Pampered Parrots Avian Rescue. Parrots remain the property of Pampered Parrots Avian Rescue for the life of the
bird. Pampered Parrots also reserves the right to visit your home to insure the Parrot's well being for the lifetime of the parrot. If
upon further inspection any of the items of this document, or the adoption cover sheet, are not adhered to, immediate
confiscation will occur. I agree to allow a representative of Pampered Parrots or Law Enforcement to enter my premises and take
any or all of the birds adopted from PPAR. If any abuse, neglect, improper care, or if the birds life is not of positive quality you
are required to submit to immediate confiscation and return of the bird. Any legal expenses incurred in recovering a bird in any
situation will be at the adopting family’s cost. By signing this document you agree to these terms in whole and are bound by
them. (Improper care will be considered any of the following:1. Any diet which does not include fresh foods on a daily basis.2.
Any diet which consists of a poor quality seed mix (made up of predominantly sunflower/peanuts)3. Any diet which contains
dangerous or unhealthy items, i.e. avocado, fried foods, sweets (donuts, chocolate, candy).4. Neglect. The adopted bird should
receive many hours of time outside of his/her cage. Birds left in cages for long periods of time (more than 8 hours a day,
exclusive of night time caging) shall be considered to be neglected.5. Lack of medical attention. Medical attention should be
sought for any adopted bird with an avian specialist veterinarian or veterinarian with a special interest in avians as soon as any
unusual behavior is noticed.)
Initial if you understand the above paragraph____________
I hereby certify that my answers to the foregoing questions are true and complete and that I have not knowingly withheld any
facts, circumstances or other information, which would if disclosed, affect my application. I further understand that any false or
misleading statement or omission of pertinent information will result in the rejection of my application, or will prompt the
confiscation of adopted bird and forfeiture of any donation fees made.
____________________________________________ ________________________
Signed Date
Please include a $40.00 donation (non-refundable) with this application. Applications without donation will not be
processed. Application donation is recovered with approval for adoption. Donations are used for food, medical, and
general care of rescue birds.
Make check or money order out to PPAR and mail to:
Pampered Parrots Avian Rescue
PO box 1644
Airway Heights, WA 99001
You my also make your donation through PAYPAL at www.paypal.com to account pamperedparrots@msn.com PayPal is free to
use and does accept credit cards.
Thank you for the time you took to fill out this application. We will contact you to set up an interview as soon as we process your
application. Average processing time is 2-4 weeks. Average length of time on waiting list is between 4 – 16 weeks.
Please note: While we strive to match birds with people who would be a perfect match of an owner in needs, personality,
and desired qualities, submission of an application does not guarantee eligibility to adopt.
Reproduction of this site in any part or in its entirety is strictly prohibited without prior permission of the author.
©2007 Pampered Parrots Avian Rescue
(mac users) if you have difficulties. Please be sure to include the application fee when you mail in your application, or use
paypal to submit it online. Application fees are used for general operation of the rescue.
Pampered Parrots Avian Rescue
Adoption Application
PO Box 1644 Airway Heights, WA 99001 Please Be encouraged to call with any questions (509) 218-3438
• All Fields Required to Avoid Immediate Ineligibility
Filling out an Application does NOT guarantee eligibility to adopt
Date________/_________/_________
Name:_______________________________________________ Age:_______________
First, Middle, Last
Previous names you have gone by:_____________________________________________
Circle One: Single Married Widowed Divorced
Spouse:_____________________________________________ Age:________________
Physical Address:_______________________________________________________________
City:______________________ State:____________ Zip:____________
Mailing Address: N/A or: _______________________________________________________
City:______________________ State:____________ Zip:____________
Please list any other states you have lived in the past 5 years:___________________________________________
__________________________________________________________________________________________
Phone:(______) ___________________ Cell/Pager_____________________ Message____________________
E-mail:_________________________________________________________
Drivers License # ____________________________ State:_______________
Children living with you: Yes_______ No________ Ages:_____________________________
List names of any other adults living with you:_____________________________________________________
Other pets or animals: Yes No Kinds:
Have you ever had an animal taken from you by the ASPCA, Humane Society, or other animal protection service? Yes
No If yes, why?
Living Situation: Own Rent House Apartment
Landlord:______________________________ Phone:(________) ____________________
Does your rental allow birds? Yes No
Smoker? Yes No Indoor Outdoor Specific room Other
Do you agree to not smoke inside if you adopt? Yes No
(Due to dangers to an avians respiratory system, answering no is an immediate disqualifier. Any evidence of smoking in
the home after adoption will result in immediate repossession of the bird.)
How did you hear about Pampered Parrots, and whom should we thank if it was a person or other organization?
Please give us detailed instructions as to how to get to your home using starting points of well known intersections e.g. I-
90/Division, Sprague/Pines. Use as many details as possible while using as many road names/crossroads as you can.
Don’t forget to describe your house/yard with color, trim or other specifics to help point it out. Attach additional sheets as
needed.
Employment: Full time__ Part time__ At home__ Student__
Job Title:_________________________________________________________
Employer:________________________________________________________
Employer address:_________________________________________________
Employer phone: __________________________________________________
Spouse Employment: Full time__ Part time__ At home__ Student__
Job Title:_________________________________________________________
Employer:________________________________________________________
Employer address:_________________________________________________
Employer phone: __________________________________________________
Household Income: Monthly gross or yearly gross (before taxes) (needed only for decision as to whether you are
financially capable of caring for parrots – food, vet care, toys, etc, Information is never shared or sold to anyone)
References – Three – May not be someone related to you or any member in your household:
________________________________ ________________________
Name Phone
How long known? _________________
________________________________ ________________________
Name Phone
How long known? _________________
________________________________ ________________________
Name Phone
How long known? _________________
Do all adults in the house know you are applying to adopt a bird? Yes No
Does anyone in your household object to your adopting a bird? Yes No
If yes, please explain:
Is there anything you would like to add or share with us?
Would you like to volunteer to staff or be part of a committee for PPAR special events such as parades, Petfest,
Bragfest, school visits and more? Yes No
1. Do you agree to a representative of PPAR visiting you in your home before Yes No
and after adoption?
2. Will you agree to take a minimum one-hour parrot education course? Yes No
3. Are you willing to take in a special needs bird? Yes No
4. Are you willing to adopt a wild, noisy, or non-hand tamed bird? Yes No
5. Are you willing to take in a pair of birds and not separate them if they are Yes No
bonded?
6. Adopting a bird for breeding purposes is not allowed. Do you agree to not Yes No
breed?
7. Would you be interested in being a Foster Parent? Yes No
8. Do you agree to not sell the bird* and return it to the rescue in the event
You can no longer care for it? Yes No
9. Do you agree to not use the bird for any kind of scientific or laboratory
testing or experiments?* Yes No
10. Would you be willing to work a minimum of 1-5 hours volunteer service Yes No
as another part of the adoption donation? (not mandatory)
11. Do you have any type of disability that may keep you from changing/ Yes No
cleaning the cage/liner or keeping food/water bowls clean?**
12. Do you have any type of disability that may keep you from feeding or Yes No
watering a bird, or giving fresh water?**
13. Do you have any type of disability that may keep you from being able to Yes No
Recover a bird from high, low, or behind places?**
14. If you answered yes to any questions 11-13, please explain disability here and if you have someone to help you
accomplish above tasks (e.g. Mother, father, caregiver, nurse) Use additional sheets as needed.
*answering no to these questions automatically disqualifies you. These questions are part of the adoption clause.
**answering yes does not disqualify you; it only aids us in matching you with the correct bird.
15.In case of emergency, do you have someone lined up that is fully capable to care for your bird(s) with little to no
notice? Yes No
If yes, may we contact them? Name & Number:____________________________________
16. Who will be the primary caregiver for the bird? __________________________________
17. Where would the bird be located in your house? ________________________________
18. Where would the bird sleep? ________________________________________________
19. Will there be children participating in the care for the bird? Yes No
20. Will they be supervised? Yes No
21. How many hors a day will the bird be left alone? ________________________________
22. How many hours a day on the weekend? _____________________________________
23. How many hours a day will the primary caregiver be gone on weekdays? ____________
24. If your present relationship should change, who would keep the bird? ________________
25. Parrots can be destructive, bite, scream, hate strangers, your mate & kids, and leave feces all over. Are you
prepared to accept these things happening in your home? Yes No
26. If your adopted parrot develops a bad habit how will you deal with it and what will you do?
27. what would need to happen for you to decide you are unable to keep the parrot you have adopted? Moving___
Divorce/Separation___ New Baby___ New Job___ Allergies___Current Pet interaction disputes___ New relationship___
Serious illness/terminal illness___Prefers one person in the family only ___ Biting ___ Screaming ___Too Noisy ___ Cannot
Spend enough time with the bird ___ The bird doesn’t talk ___ The bird does not perform ___
Complaints from neighbors ___ Expenses become too much ___ Other _________________
___________________________________________________________________________
28. Please tell us why you would be a good candidate for parrot adoption and if you have had any past pet bird experience.
Please include any past ownership, how long you owned them, and if you no longer own them please explain why not. Be as
thorough as you can. Attach additional sheets as needed.
29.What type of bird(s) would you be interested in adopting? Please name species, size, age, noise level, or anything else that
may help us find the perfect match. Attach additional sheets as needed.
30. Do you currently have an Avian Certified Vet or a qualified Vet with a special interest in
Avians? Yes No
31. If yes, may we have permission to contact your vet for references?
Name & number of vet:_________________________________________________________
32. If you do not have a vet, may we suggest one to you? Yes No
Be sure to initial and sign Contract Inclusions found HERE
Also read and sign 10 things you need to know before adopting a bird: HERE
If at any time during the life of the parrot, if the adopting person(s) no longer wishes to keep the parrot, the parrot must be
returned to Pampered Parrots Avian Rescue. Parrots remain the property of Pampered Parrots Avian Rescue for the life of the
bird. Pampered Parrots also reserves the right to visit your home to insure the Parrot's well being for the lifetime of the parrot. If
upon further inspection any of the items of this document, or the adoption cover sheet, are not adhered to, immediate
confiscation will occur. I agree to allow a representative of Pampered Parrots or Law Enforcement to enter my premises and take
any or all of the birds adopted from PPAR. If any abuse, neglect, improper care, or if the birds life is not of positive quality you
are required to submit to immediate confiscation and return of the bird. Any legal expenses incurred in recovering a bird in any
situation will be at the adopting family’s cost. By signing this document you agree to these terms in whole and are bound by
them. (Improper care will be considered any of the following:1. Any diet which does not include fresh foods on a daily basis.2.
Any diet which consists of a poor quality seed mix (made up of predominantly sunflower/peanuts)3. Any diet which contains
dangerous or unhealthy items, i.e. avocado, fried foods, sweets (donuts, chocolate, candy).4. Neglect. The adopted bird should
receive many hours of time outside of his/her cage. Birds left in cages for long periods of time (more than 8 hours a day,
exclusive of night time caging) shall be considered to be neglected.5. Lack of medical attention. Medical attention should be
sought for any adopted bird with an avian specialist veterinarian or veterinarian with a special interest in avians as soon as any
unusual behavior is noticed.)
Initial if you understand the above paragraph____________
I hereby certify that my answers to the foregoing questions are true and complete and that I have not knowingly withheld any
facts, circumstances or other information, which would if disclosed, affect my application. I further understand that any false or
misleading statement or omission of pertinent information will result in the rejection of my application, or will prompt the
confiscation of adopted bird and forfeiture of any donation fees made.
____________________________________________ ________________________
Signed Date
Please include a $40.00 donation (non-refundable) with this application. Applications without donation will not be
processed. Application donation is recovered with approval for adoption. Donations are used for food, medical, and
general care of rescue birds.
Make check or money order out to PPAR and mail to:
Pampered Parrots Avian Rescue
PO box 1644
Airway Heights, WA 99001
You my also make your donation through PAYPAL at www.paypal.com to account pamperedparrots@msn.com PayPal is free to
use and does accept credit cards.
Thank you for the time you took to fill out this application. We will contact you to set up an interview as soon as we process your
application. Average processing time is 2-4 weeks. Average length of time on waiting list is between 4 – 16 weeks.
Please note: While we strive to match birds with people who would be a perfect match of an owner in needs, personality,
and desired qualities, submission of an application does not guarantee eligibility to adopt.
Reproduction of this site in any part or in its entirety is strictly prohibited without prior permission of the author.
©2007 Pampered Parrots Avian Rescue
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