Please fill out this form completely so we can submit your order correctly. Thanks :)


We want to thank you for your order.

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Species of bird/Quantity:

The following Questions are for research ,and customer service use only. In no way shape ,or form will this informaiton be exchanged ,or sold to anyone.. This info is so we can better server your needs ,and for you to adopt a bird to suit your lifestyle that your whole family will enjoy, and love. � Also , so that in the case of other pets ,and children special instruction information, and care can be provided, and instituted in reference to relationships of possible other pets in your home, and /or young children, and handling these sensitive situation. The following questionaire is completley voluntary, and will not affect the sale of your bird. The more we know , the more informed you will be about your specific needs/situation and smoother the transition for everyone. Remember birds live a long time.

Parakeets (10-15 years) to Amazons 60-70 yrs to Macaws who have been recorded living over 90-100 years (some species)

Thank you for your coorperation and Good Luck!

"Questionaire"

1. Have you ever owned a bird before?

2. If yes. What species/how many/how long ago/what happened?

3. Do you have any other pets in the house )cats/dogs/ferrets/etc.)

4. Do you have children? If yes what age range?

infant to 2

2-5

5-9

10-14

15-18

18-21

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What kind of lifestyle do you live? (9-5 worker,house wife/homemaker , work days/nights?)

Do you APT/House ,or own home , or multidwelling/apartment building?

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Name:�


Address�


City, state , Zip���


Mailing address if diffrent�


City , State, Zip


Phone�

Credit Card Billing Address: �������������

City:����

State:��Zip:����

Phone:��

E-Mail:�� 

THE EXACT NAME & BILLING ADDRESS OF THE CREDIT CARD YOU ARE USING IS REQUIRED

How will you be paying?
Other Card name:
Card Number:
Expire Date:

Additional Comments or Information: Please tell us here exactly what you want to order. Make sure the exact thing is typed here so we can get your order correct. Thanks.
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