Our contract requires that if you cannot keep the bird for any reason, you MUST return the bird to our program. Do you agree to this requirement? *
- Select Option -
Yes
No
Bird you would like to adopt:
Adele (Parakeet - 0000000330)
Alanis (Parakeet - 0000000339)
Aretha (Parakeet - 0000000334)
Billie (Parakeet - 0000000335)
Bing (Cockatiel - 0000000351)
Bob Parr (Parakeet - 0000000287)
Bud (Amazon - 0000000369)
Carmi (Cockatoo - 0000000230)
Elmer (Parakeet - 0000000295)
Etta (Parakeet - 0000000336)
Eva Marie (Parakeet - 0000000357)
Freddie (Parakeet - 0000000346)
Gracie (Conure - 0000000365)
Hall (Parakeet - 0000000260)
Helen (Parakeet - 0000000286)
Hoshi (Cockatoo - 0000000380)
James (Parakeet - 0000000342)
Jenga (Poicephalus - 0000000125)
Jerry (Cockatiel - 0000000236)
Kai (Parakeet - 0000000268)
Lil (Lovebird - 0000000375)
Little Wing (Cockatiel - 0000000324)
Looney (Lovebird - 0000000376)
Lucky (Parakeet - 0000000360)
Lucy (African Grey - 0000000384)
Makani (Parakeet - 0000000269)
Mercury (Parakeet - 0000000347)
Mick (Parakeet - 0000000348)
Midna (Parakeet - 0000000361)
Nick (Lovebird - 0000000377)
Nina (Parakeet - 0000000337)
Noble (Poicephalus - 0000000124)
Oates (Parakeet - 0000000259)
Ozzie (Parakeet - 0000000349)
Peetie (Macaw - 0000000381)
Pete (Parakeet - 0000000344)
Phil (Lovebird - 0000000374)
Queen (Parakeet - 0000000332)
Ricki (Cockatoo - 0000000320)
Roger (Parakeet - 0000000345)
Roman (Cockatiel - 0000000323)
Sade (Parakeet - 0000000338)
Shania (Parakeet - 0000000331)
Shiloh (Conure - 0000000387)
Sky (Parakeet - 0000000382)
Spike (Cockatiel - 0000000373)
Sydney (Cockatoo - 0000000379)
Taylor (Parakeet - 0000000343)
Tom (Cockatiel - 0000000235)
and/or...
Species Interest 1:
African Grey
Amazon
Caique
Canary
Cockatiel
Cockatoo
Conure
Dove
Eclectus
Finch
Lorikeet
Lovebird
Macaw
Mini Macaw
Parakeet
Parrotlet
Pigeon
Pionus
Poicephalus
Unknown/Other - Large
Unknown/Other - Medium
Unknown/Other - Small
Unknown/Other - X-Large
x Foster Applicant x
x Volunteer Applicant x
Contact Information
First Name *
Last Name *
Street Address *
City *
State *
Zip Code *
Phone Number *
Alternate Phone Number
Email Address *
Date of Birth *
How did you find out about us? *
- Select Option -
Event
Petfinder
Internet Search
Family/Friend
Staff/Volunteer
Facebook/Twitter
Previous Adopter
PetSmart
Vet
Another Shelter
Somewhere Else
Residential Information
How long have you lived at this address? *
- Select Option -
Less than one month
1-2 months
3-6 months
6-9 months
9-12 months
1-2 years
3-5 years
6-10 years
10 + years
Type of Residence *
- Select Option -
House
Apartment
Condo
Other
Do you own or rent your home? *
- Select Option -
Own
Rent
Someone else owns the Home
Someone else rents the Home
If you rent or lease, does your landlord and lease allow pets? *
- Select Option -
Yes
No
Unsure
N/A
Please Provide Landlord Contact Information *
Family Demographics
Including yourself, how many people live in your household? *
- Select Option -
1
2
3
4
5
6
7
8
9
10+
Please list the names, ages & relationship of those who live in your home. *
Will you allow us to perform a homecheck? *
No Yes
Will you allow us to perform a background check on all adults over the age of 18? *
No Yes
Does anyone in your home have asthma or allergies? *
No Yes
Do you use nonstick coated cookware? *
No Yes
If yes, please explain (i.e. what kind of non-stick)
Does anyone who resides in or visits your home use smoking or tobacco products? This would include vape, e-cigs, cigars, cigarettes, or any substance that produce smoke. *
No Yes
Please elaborate *
Bird Knowledge
Please give us a details about any bird experience that you may have?
Are you aware that exotic birds could potentially carry diseases that could affect humans? *
No Yes
Did you know that it isn't safe to use scented plug-ins, air fresheners, candles or etc. around a bird? *
No Yes
Employment Information
Employment Status
- Select Option -
Full-Time
Part-Time
Retired
Work from Home
Stay at Home Parent
Student
Unemployed
If you are employed, what is your current occupation, name of employer, and address?
If you are not currently employed, please elaborate on how you are able to be financially responsible for your bird's food, toys, cage, and vet care?
Potential Bird Information
Why are you interested in adopting a STAR bird? *
Want a Companion for Myself or Family
Want a Companion for Another Pet
Looks Pretty
For Breeding
As a Gift for Someone Else
Had One Before/ Have One Now
What are the most important characteristic you are looking for in a bird? *
Are you aware the birds might have or could develop habits that could cause injury to people or damage property? *
No Yes
Will you leave your TV, radio, or some other audio/video on for your bird? *
No Yes
How often will you clean and disinfect the cage? *
How much time outside of the cage will your bird spend for exercise and entertainment? *
How much time will your bird spend alone? *
What will you feed your bird? *
Describe how you will bathe your bird.
How will you handle destructive behavior if developed? *
Do you understand cage requirements for the species that you are applying for and agree to supply that for your bird? *
No Yes
Would you be willing to attend a class on basic bird care if available? *
No Yes
Current Bird Information
Have you ever had birds? *
No Yes
If you no longer have these birds, what happened to them? *
Please list any birds you have. (Name, Species, Age, How long you have had this bird., Date of last vet visit.) *
Who is/ will be the caregiver for the birds?
When you go on vacation, who does/ will care for your bird(s)?
How often do you/ will you take your bird to the vet?
Current Other Pet Information
Do you currently have any other pets besides birds? *
No Yes
Please all other pets in the household, including species/breed, age, time owned, spayed/neutered status, date of last vet visit. *
Have you ever had any animals that you no longer have? Please explain the reason why. *
Avian Veterinarian Information
Veterinarian's Name
Veterinarian's Address, City, State, and Zip Code
Veterinarian's Phone Number
If the name that any of your current birds are listed under at the clinic provided is different from the name on your application, please provide that information here
Do you agree to take your bird to the vet at least annually for a wellness exam as recommended by the AAV? *
No Yes
General Veterinarian Information (Other Pets)
Veterinarian's Name
Veterinarian's Address, City, State, and Zip Code
Veterinarian's Phone Number
If you have cats or dogs in your household do you certify that they are up to date with any mandatory vaccines and have been seen by a veterinarian for a wellness exam within the last year?
N/A
Yes
No
If the name that any of your non-avian pets are listed under at the clinic provided is different from the name on your application, please provide that information here
If any of your current pets have not seen a vet for a yearly wellness exam, please explain:
VETERINARY INFORMATION RELEASE:
I hereby authorize the release of ALL medical records pertaining to the listed animal(s) to representatives of St. Louis Avian Rescue (STAR).
PLEASE READ CAREFULLY.
This is not meant to intimidate you nor to cast a negative light on exotic birds. Rescued birds are no more and no less likely to behave in an aggressive or unpredictable manner than any others. But, Saint Louis Avian Rescue wants to make you aware of possibilities when working with them.
The birds that Saint Louis Avian Rescue place have been surrendered, abandoned, or in some way displaced. They may have been abused or neglected. There may only be limited information available regarding their previous environment. S.T.A.R. will share with you what information we have. There will be an adjustment period. Remember to be patient, consistent, and understanding.
Avian medicine is a relatively new discipline. It is possible for a bird to be a carrier of, or infected with, a disease that is undetectable with the current tests and tools available today. Therefore, you should quarantine any bird new to your flock. We recommend a period of at least 30 days – 90 would be even better.
If a bird is placed with you, you will be responsible for providing appropriate food, water, and loving attention. Many parrots have an extremely long life expectancy. Please think carefully about this. Are you ready to make this commitment?
I certify that I have never been charged with nor convicted of animal abuse or neglect in Missouri or any other state. I certify that no one in the household where this bird would reside has been charged with nor convicted of animal abuse or neglect in Missouri or any other state.
Please Initial:
I certify that any bird adopted will NOT be placed into a breeding situation. I certify that should I not be able to or not want to properly care for this bird, or in the event of my death, the bird will be returned to St. Louis Avian Rescue. *
No Yes
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal. *
No Yes
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