Quaker Parakeet Society
Rescue and Placement Program
First Name: _________
Are you over 18 years of age?_
(if under 18, see *note* at bottom)
Box or Apt.:___________
Check one or more areas of RAPP volunteering you may
be interested in:
_______RAPP Support (support, education and mentoring)
How many hours per week do you have for volunteer work?
Do you have a valid driver's license? ______
Do you own or have access to a vehicle? _______
How far are you willing to travel to participate in
transport, placement or rescue?_____
Do you presently own 1 or more Quaker Parrots?____
If yes, how many?_______
Do you presently own other species of birds?_____
If yes, what species and how
Do you breed birds?_____
If yes, as a _____hobby or _____source of income
Does your residence allow space for quarantine?______
Do you use an avian vet/vet?_____
If yes: name of avian vet/vet:__________
Have you adopted, rescued or fostered birds in the
past?, (not including those birds purchased through pet stores or
Do you have equipment that may be necessary for
transport, fostering or adoption? (i.e.: travel cages,
Are you currently a member of any bird clubs, societies and/or
Why do you want to become a volunteer?
How did you hear about QPSRAPP and what motivated you to apply
as a volunteer:________
Upon submitting, this form will be sent for review to the QPSRAPP committee.
Please be advised that there may be a waiting period before becoming an eligible adopting volunteer. You will receive a response from the committee shortly, including the QPSRAPP Welcome Letter. If you experience any difficulties sending the application, it can be copied and pasted into email and sent to: firstname.lastname@example.org or email@example.com or sent by regular mail to:
QPS-Rescue and Placement Program
2475 Crescent Ave.
Eugene OR 97408
Thank you for volunteering and helping to change the world one Quaker Parrot at a time.
QPSRAPP has the right to decline any application that would appear unable to conform with, or be in conflict with, required QPSRAPP volunteering guidelines*
If applicant is under 18 years of age, you must print this application and have a parent or legal guardian sign it and have it notarized, then mail it to the above address.
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