Pacific Northwest ApplicationPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Pacific Northwest applicants for Nina's Last Flock only(Washington, Oregon, Idaho, Montana)For additional assistance, join Palomacy's Help Group at www.Facebook.com/groups/Palomacy * indicates response requiredFirst Name & Last Name *FirstLastPronounsShe/HerHe/HimThey/ThemEmail *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIs this the address where the birds will be located? *YesNoNote: if no, please provide the address where the bird will be located.Alternative Bird Location AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSocial Media Names?Primary Phone *Emergency Contact Name & Phone Number *Name of Foster/Adopter seeking approval: *Note: fosters/adopters must be 18 or overDate of birth: *Please list names, ages & relationships of everyone in the homePlease briefly describe your education, employment &/or special skillsAre you interested in DOVES, PIGEONS or BOTH? *DovesPigeonsBothI need more informationPlease tell us why you would like to foster or adopt *Do you want to FOSTER or ADOPT? *FosterAdoptFoster to AdoptI need more informationWho will be the bird's primary caretaker? *Who will be the bird's secondary caretaker?In case of illness, travel, etc. List age if under 18.Now much time per day do you expect to be caring for the bird(s)? *How often do you travel? *RarelyA couple times a yearFrequentlyType of dwelling: *HouseApartmentCondoOtherType of dwelling — OtherDo you rent or own? *RentOwnIf you rent, do you have your landlord's consent to have a bird? *YesNoLandlord's nameLandlord's phone numberHave you ever had birds? *YesNoIf yes, what kind, how many of each & where are they now? *Are you aware that pigeons and doves have a 10-20 year lifespan? *YesNoDo you understand that Palomacy's birds can never be free-flown? *YesNoI need more informationDo you understand that, because there are so many in need of homes, Palomacy birds must not be allowed to breed? *YesNoI need more informationDoes anyone in your household smoke? *YesNoIf yes, would you be able to provide a smoke-free environment for a foster or adopted bird? *YesNoAre you aware that birds are very sensitive to & require protection from fumes & airborne toxins such as Teflon vapors, cleaning products, paint fumes, etc? *YesNoI need more informationDo you have other animals? *YesNoWhat animals do you have?Have you ever sold or given away or otherwise rehomed a pet? *YesNoIf yes, why?How many and what kinds of birds would you like to foster or adopt from Palomacy?If a bird needs supportive care (isolation from other birds, indoors, access to a heating pad, possible supplement feeding) while recovering from an illness or injury, can you provide it? *YesNoI need more informationWhere would the birds that you foster or adopt from Palomacy live, INSIDE or OUTDOORS or BOTH? *IndoorsOutdoorsBothI need more informationAre you aware that indoor birds require special lighting or natural sunlight unfiltered by glass for their health and well being?YesNoI need more informationAre you aware that pigeons & doves can wear diapers while indoors &/or a harness outside?YesNoI need more informationIf INSIDE, please describe the cage/enclosure, its dimensions & the location you have in mind to use.Please confer with Palomacy before getting anything. Please attach photos or screenshots of the cage and location you have in mind. Click or drag files to this area to upload.You can upload up to 5 files. If your fostered/adopted birds will live OUTDOORS, do you already have an aviary/coop/loft or something in mind?YesNoI want to create oneCages are not safe for outdoor use. Please confer with Palomacy before creating an outdoor enclosure. If yes, what are the dimensions & building materials?How many birds currently live in it, and what types?What is the maximum number of birds you'd keep in it?Is this enclosure predator and rodent-proof?YesNoI need more informationPlease attach photos or screenshots of the aviary/coop/loft you own or have in mind. Click or drag files to this area to upload.You can upload up to 5 files. Will you permit a site visit & post-placement follow-up to your premises by a Palomacy volunteer? *YesNoWill you provide Palomacy with periodic updates on & pictures of the birds that you foster or adopt? *YesNoUnder what circumstances would you NOT wish to keep the bird? *MovingNew JobAllergiesDivorce/SeparationLoud/NoisyDoesn't get along with other petsNew BabyBiting/Aggressive to pets or humansBird develops serious illnessBird prefers one person more than anotherCommitted to figuring out how to keep bird(s) have sunlight the Please rate these characteristics as important or not important to you.Age *ImportantNot ImportantBreed *ImportantNot ImportantSex *ImportantNot ImportantHealth/Special needs *ImportantNot ImportantTemperment *ImportantNot ImportantColor *ImportantNot ImportantSignature * Clear SignatureDo you have any comments, questions or concerns regarding your application to foster or adopt Palomacy birds?Custom Captcha * = THANK YOU!Submit Application
