CRR FOWL ADOPTION APPLICATION

CRR ADOPTION APPLICATION

To adopt from Chicken Run Rescue:

Fill out the application form below and click the submit button.

First name M.I. Last name

Street address

Mailing address

City State Zip Code

Home Phone Work Phone Cell

Children Ages

Which birds are you intersted in adopting (name of individual bird or general description)

Why are you interested in adopting?

How many chickens do you have now? How many hens? How many roosters?

How many small (up to 2 lbs.)? How many medium (2-6 lbs.? How many large (over 6 lbs.)?

How many chicks? How many juveniles? How many adults? How many seniors?

Have you had domestic fowl in the past?-- Yes -- No

If so, where are they now?

Years of experience with chicken care:

Have you taken a class about chicken care? Yes -- No

Who taught the class?

Which best describes the property where the birds will live:

Describe other:

Do you raise any animals for slaughter?-- Yes -- No

Do you breed any animals? -- Yes -- No

Does your muncipality require a special permit for chickens or other domestic fowl? -- Yes -- No

If yes, what is the status of your special permit:

Which best describes the building(s) where the chickens will live:

Describe other:

What are the interior dimensions of the structure? Height Width Length

Can you maintain a minimum of 32 degrees F in the building in the coldest period in winter? - Yes - No

Is there a heat source in the building? -- Yes -- No If yes, describe

Is the building insulated? -- Yes -- No

Which best describes the outdoor area(s) where the chickens will exercise when unsupervised:

Describe other outdoor area:

If fenced pen or yard, describe fence material & height

Dimensions of outdoor area:

Which best describes the outdoor area(s) where the chickens will exercise when supervised:

Hours per day of adult supervision

Where do you care for sick or injured birds?

Describe other:

Do you have additional areas available suitable for introduction or isolation? -- Yes -- No

Describe area:

What do you feed your chickens?

Have you ever lost animals to predators? -- Yes -- No

Please indicate which predators are present in your vicinity:

Raccoon -- Dog --Coyote --Fox --Mink --Opossum --Rat --Owl --Bobcat Hawk --Snake --Weasel --Ferret --Fisher --Marten

Other

What predator precaution measures do you have in place?

Fencing Electric Fencing Infrared Lights Sound Monitor Guard Animals (i.e. dogs or other species who deter predators)

Other

Are you able to lock up the coop completely at night? -- Yes -- No

Please list other companion animals you care for:

What veterinary clinic or vet do you use for your animals? (name, address and phone)

Would you like to be contacted about other animals who need homes? Check all species you would consider: Ducks -- Geese --Pheasants --Guinea Fowl --Pea Fowl --Goats --Sheep --Pigs

Have you read CRR's Summary of terms for adoption? -- Yes -- No --- If not, please click here.

Your e-mail address has been added to our list to receive The Chicken Run Rescue Adoption Chronicles. The notices contain a link to personalit profiles and photos of the birds who are available for adoption and contain information about chicken care from the perspective of those who respect and advocate for them. We average about one message a month. People seem to really enjoy the pictures and stories. If you wish to be removed, contact chickenrunrescue@comcast.net with "unsubscribe" in the subject field.