Association for Parrot C.A.R.E.
Conservation, Adoption, Rescue, Education
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Bequest Form

Please complete the fields below and we will respond to your inquiry.
Gaurdian's First Name:
Gaurdian's Last Name:
Parrot's Name:
Parrot's Age:
Parrot's Hatch Date (if known):
Address Street :
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Lawyer's Firm:
Lawyer's Name:
Lawyer's Direct Number:
Lawyer's Email:
Policy Number on which Association for Parrot C.A.R.E is beneficiary:
Executor or Insurance/Investment Co Name:
Veterinarian Name:
Veterinarian's Phone:
Veterinarian's Clinic Name:
Veterinarian's Clinic Phone:

Upon my death or demise, I hereby donate to Parrot C.A.R.E. the above listed bird(s) to be placed in Serenity Park Sanctuary and release all medical records for the above listed bird(s) to authorized representatives of Parrot CARE.  I relinquish all claims to the above listed bird(s) and any future progeny.

 		 Terms and Condtions
Date:
Addiitonal Info:

 

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