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Live Bird Request Form
Alaska Wild Bird Rehabilitation Program
PO Box 521317, Big Lake, AK 99652-1317
907-892-AWBR (2927)
www.akwildbird.org
education@akwildbird.org
EIN # 14-1958727

Requests for birds should be made at least four weeks in advance of the program date.
Price rates: $65.00 per program for all birds except the Sandhill Crane that is $85.
Each program is one bird for one hour or part thereof.
($10 additional per bird out of core Mat-Su area)
Payment can be made by cash, check (payable to: AWBRC).

Organization *
Your answer
Contact Name *
Your answer
Phone Number *
Your answer
e-mail *
Your answer
Billing Address *
Your answer
Program Dates *
Please give three program dates in order of preference.
Your answer
Program Times *
Please give three program times in order of preference.
Your answer
Program Location *
Your answer
Audience Age or Grade *
Your answer
Audience Size *
Your answer
Special Requests
Your answer
Type of presentation *
Required
Number of birds requested *
Your answer
Bird Species
Select your preferred bird species in priority order where column #1 is your first choice, etc.
1
2
3
4
Red-Tailed Hawk
Short-eared Owl
Great Horned Owl
Great Grey Owl
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