Majestic Waterfowl Sanctuary: Online Adoption Application

I am applying to adopt the following duck/goose:

SELECT ONE Goose Pair - Mac and Fanny Duck - Rosella Duck Pair - Lilly and Piper Duck Pair - Asaru and Tiwana Duck Pair - Aladdin and Jasmine Duck Pair - Winston and Mr. Pearl
View Profiles of Ducks and Geese available for adoption

Do you want to:

pick up the duck or goose in person? 
have the duck shipped to you? (Rarely available, please inquire via email prior to selecting.)
We do not ship to most regions. We do not ship geese. We only ship those ducks who we feel can safely handle the journey, both physically and emotionally. For further details click here.

What is your PayPal Account Email Address? (See Note below):

Note: We need your PayPal account email address in order to match adoption fee payments with adopter names. Required only if you will be paying your adoption fees online via PayPal.

Why do you want to adopt this duck or goose? (Check all that apply):

Family Pet
Mate or Companion for other duck(s) or goose/geese
Addition to Flock
4-H
Breeding purposes
Other:  (Please explain)

Where do you intend to keep the duck or goose you adopt? (Check all that apply):

At my residence
Other: (Please say where)

Who owns the property where the duck or goose will be kept? (Check all that apply):

Myself
Spouse
Other Family Member
Other:   (Please say who)

Type of Property: (Check all that apply):

House 
Farm or Ranch
Apartment
Other:  (Please describe)

# of adults living at property where duck/goose will be kept:
# of children (under 18) living at property where duck/goose will be kept:

Are any of the adults or children referenced above allergic to birds? Yes  No
If yes, please list who: 

Who will be the person(s) responsible for the feeding and care of the duck or goose? (Check all that apply):

Myself
Spouse
Other Family Member
Other:  (Please say who)

Will the duck/goose have access to bathing water on a daily basis?  Yes   No

If yes, please specify (Check all that apply):

Natural Pond or Lake
Man-Made Pond
Kiddie Pool
Bathtub in House
Other: (Please describe)

Will the duck/goose be housed with other animals? Yes  No

If yes, which kind?  (Check all that apply):

Duck(s)
Goose/Geese
Chicken(s)
Turkey(s)
Other: (Please describe)

What will you feed the duck/goose? (Check all that apply):

Mazuri Waterfowl Starter
Mazuri Waterfowl Maintenance
Mazuri Waterfowl Breeder
Blue Seal Game Bird Starter / Grower Crumbles
Blue Seal Grower Cal Pellets / Unmedicated
Blue Seal Layer / Breeder Pellets
Purina Duck Starter
Purina Flock Raiser Sunfresh Recipe
Purina Layena
Purina Gamebird
Cracked Corn
Oyster Shells / Calcium Chips
Grit
Vegetables
Chopped, hard boiled eggs (with shells)
Grass
Other: (Please say what)

Will the duck/goose have fresh drinking water 24 hrs/day? Yes   No

Do you have veterinarian that can treat waterfowl?  Yes   No
If yes, name of veterinarian: 
Telephone number of waterfowl veterinarian:
May we contact this vet?  Yes   No

Please describe the type of enclosure you will provide during the daytime
(Check all that apply):

Free Range: Fully Fenced
Free Range: Partially Fenced
Free Range: Stone Walls
Free Range: No Fence
Fenced in Lawn
4-Sided Pen/Structure
Top Fencing / Aviary Netting
Bottom Barrier (buried fencing or foundation)
Digging Predator Barriers (underground fence surrounding the perimeter fence)
Inside House
Other: (Please describe)

Will the duck/goose have access to daytime shelter? Yes   No

If they have a pen, will it be locked or latched? Locked  Latched

Please describe the type of fencing on the daytime enclosure (Check all that apply):

Privacy Fencing (no spaces between boards)
Decorative Fencing (open spaces between boards)
Chain Link Fencing
Galvanized Wire Fencing (including PVC coated)
Poultry Wire / Hex Wire
Welded Wire Mesh
Electric Fencing
Barbed Wire
Other: (Please describe)

If wire fencing, please indicate the weave size of your fencing by indicating the Length x Width of the largest openings in the wire (i.e. the measurement of the squares, rectangles, hexes, etc.):

inches   by   inches

If decorative fencing, please indicate the amount of spacing between boards:

inches

Please indicate the height of your fencing at its lowest point:

feet

Please describe the type of shelter you will provide during the nighttime
(Check all that apply):

Barn
Shed
Inside House or Garage
Duck or Goose House
Other: (Please describe)

Will the nighttime enclosure be locked or latched? Locked   Latched

Please indicate the dimensions of your nighttime housing:

feet   by   feet   by   feet

Does the nighttime housing have flooring: Yes  No

Is the nighttime housing located within a fenced in area: Yes   No

Please describe, in as much detail as possible, the environment the duck or goose will live in. Examples: any further details you'd like to add about shelter and housing description, daily routine, feeding schedule, interaction with humans or other animals, etc.:

Please tell us anything else you think we should know in order to best evaluate your application:

Photos:

After submitting this adoption application to us, we will contact you for photos of your daytime enclosure, nighttime shelter and any other relevant photos. Please be sure photos are clear and bright. Send us enough shots to allow us to visualize a full 360 degree view of your pens and houses. If you need to mail photos to us* you can send them to:

Majestic Waterfowl Sanctuary
17 Barker Road
Lebanon, CT 06249

*Please include a SASE if you would like your mailed photos returned to you.

Which type of photos will you be sending us upon our request? 

Emailing Digital Photos  Snail Mailing Photos

Certification:

I certify that the information given is true and correct and I recognize that any misrepresentation of facts will result in my losing the privilege of adopting a duck or goose. I also give my veterinarian permission to release any vet care records and information about my current and past pets to the Majestic Waterfowl Sanctuary. I understand that this application is the property of the Majestic Waterfowl Sanctuary and that the Majestic Waterfowl Sanctuary has the right to deny my request to adopt.

Select One I have read and understand the above statement.