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Adoption Application
Capital District Pet Bird Club
Prior to completing this application, please be advised that:
1. It is the goal of the Capital District Pet Bird Club to provide
loving and lasting homes for rescued, abandoned, and abused birds. We
also work to provide homes for birds whose owners (for whatever reason)
can no longer care for them.
2. When birds are placed with new owners via the CDPBC, it is with the
understanding that under no circumstances are the birds to be sold or
given away. Should extenuating circumstances occur whereby the new
owner cannot keep the bird, that bird becomes the property of the CDPGB
and must be returned to us for re-adoption.
3. It is a requirement of our club adoption program that you join our
organization. Dues are $20 per year and entitle you to an informative
quarterly newsletter, attend free meetings and special events. (Consult
the membership page of this website.)
I understand and agree to the above stipulations:
Signature: _________________________ Date: ______________
* * * * * * * * * * * *
Date of application:
Name of applicant:
Street address:
City, State. Zip:
Home phone:
Work/cell phone:
E-mail:
Please provide answers to all of the following information:
1. I was recommended as a great bird person by:
2. Do you presently have any birds? If so, what kind and how many?
3. If you do not have birds presently, did you ever own birds?
4. Who is your avian veterinarian?
5. If you do not have a veterinarian, are you willing to choose one
from our recommended list?
6. Are you willing to receive free training to become a bird owner (or
a better bird owner)?
7. What type of diet do you provide for your birds?
8. Are you presently a bird breeder? If so, what kind of birds?
9. Does anyone in your household smoke? If so, would all smokers be
willing to smoke outside? (Smoke is very deadly to your bird's little
lungs - even secondhand smoke on your hands and clothes.)
10. What other pets do you have in your home?
11. How many people are in your household?
12. Do you live in an apartment or a private home?
13. Why do you think you would make a good bird owner?
14. Would you be interested in rehabilitating a problem bird, such as a
screamer or biter?
15. Are you interesting in participating in bird "rescue?"(This is
where you are called upon to rescue a bird from a bad situation.)
16. Is there a particular breed of bird that you are interested in
adopting?
Please return this form to:
Joyce Rockenstire
35 Killean Park
Albany, NY 12205
crocken1@nycap.rr.com
Phone 518-464-9283 between 9 am and 9 PM
bravenet.com