CRR FOWL ADOPTION APPLICATION

CRR ADOPTION APPLICATION

To adopt fowl from CRR:

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

How many chickens or other domestic fowl do you have now? [Please list species (chickens, ducks, geese, other), breeds (ie large, medium or Banti), and approximate age] ?

How many hens do you have?

How many roosters do you have?

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

If so, where are they now?

Years of experience with chicken care:

If adopting ducks, years of experience with duck care:

What kind of swimming water do you have for the duck? (describe)

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

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

Describe other:

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

Is the building insulated? -- Yes -- No

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

Dimensions of outdoor area:

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

What predator precaution measures do you have in place?

Please list other companion animals you care for:

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

Have you read CRR's Summary of terms for adoption? -- Yes -- No --- If not please do so.