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How experienced are you? Select only 1

Novice

Somewhat Experienced

Very Experienced

READY for a Challenge

What species of Parrots are you interested in adopting? (Please be specific.)

About You

Full Name

Address

Email

Home Phone

Cell Number

Your age

Best time to reach you?

Are you a LIPS member?

Tell us about your Parrots and other pets that live with you.

How many parrots currently reside in your home? Please list details of each parrot, include species, ages and how long you have owned.

List each parrot by species, age, and how long the parrot has lived with you.

If no current parrots in the home, please tell us about your past experience with parrots.

Do you have other pets in your home?

Please list all, including details.

Residential Information

Residence Type

Rent or Own?

Landlord Information - If you RENT please complete landlord section below.

Do you have your Landlord's consent to obtain a parrot?

Landlord's Full Name

Landlord's Address

Landlord's Phone Number

I understand that LIPS performs mandatory home inspections* prior to adoption and may perform additional random visits before and after parrot is placed with me. I agree to permit scheduled home visits* of my home.

*Home inspections/visits may be performed virtually via Zoom

Please agree to the above statement

Yes

No

Would you consider FOSTERING a parrot that needs to be placed quickly in an emergency?

Once again, in the event you are unable to keep the parrot: You must alert LIPS Parrot, Foster and Placement Program of this decision immediately. You can either return the parrot to the former owner if you had made previous arrangements to do so, or the parrot will be re-homed by the LIPS Parrot, Foster and Placement Program.

Please remember that LIPS has made a commitment to the relinquishing owner and to the parrot that we will honor now and in the future.

Applicant Signature

Your typed name represents your signature.

Application Date

(APPLICATION EXPIRES ONE YEAR FROM THE THIS DATE)

Your form has been submitted. Thank You!