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: $75.00 per program for all birds.
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 *
Contact Name *
Phone Number *
e-mail *
Billing Address *
Program Dates *
Please give three program dates in order of preference.
Program Times *
Please give three program times in order of preference.
Program Location *
Audience Age or Grade *
Audience Size *
Special Requests
Type of presentation *
Required
Number of birds requested *
Bird Species
Select your preferred bird species in priority order where column #1 is your first choice, etc.
1
Red-Tailed Hawk
Clear selection
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