Please fill in all fields marked with a *
	First Name	*
	Last Name	*
	Phone Number	*
	Alt Phone Number	*
	Address	*
	City	Calgary, AB.Airdrie, AB.Cochrane, AB.Chestermere, AB.Strathmore, AB.Other*
	City Other
	Postal Code	*
	Other Pets	Dogs Cats Reptiles Other *
	Other Pets Description
	Other Birds 1	*
	Other Birds 2
	Are you a Breeder	Yes No *
	Are you a Hobbyist	Yes No *
	Are you a Collector	Yes No *
	Do you have Children under 10 years old	Yes No *
	Do you have Children 11 to 18 years old	Yes No *
	Do you own or rent your home	OwnRent*
	If rent do you have a permission letter	Yes No *
	Type of Bird interest in	Small (Finch / Canary / Budgie / Cockatiel / Lovebird)Medium (Conure / Pionus / Senegal / Amazon / Grey / Cockatoo)Large (Macaw / Umbrella / Moluccan)*
	Specific Bird Breed
	Experience in bird behavior modification like Plucking or Biting and Screaming	Yes No *
	Interested in working with a bird needing behavior modification	Yes No *
	I have Read the adoption terms on the website	Yes No *
	I your full name	*
	agree to the terms and conditions of Calgary Adopt A Parrot	Yes No *
	Date	*
	Comments
	email	*