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Department of Land and Natural Resources Division of Forestry and Wildlife Wildlife Rehabilitation Permit Application See attached instruction page for information on how to complete this application and help avoid unnecessary delays. Return to: Hawaii Division of Forestry and Wildlife Administration Office – Permitting 1151 Punchbowl Street Rm. 325 Honolulu, Hawaii 96813 Application Date: New Permit_______ Renewal__________ Previous Permit No.__________________ Complete if applying as an individual Name (First, Middle, Last) and Title of Principal Permittee Date of Birth (mm/dd/yyyy) Affiliation/ Doing business as: Physical Address: Mailing Address: E-mail Address Telephone Number _______________________Fax Number __________________________ 2008 DOFAW Wildlife Rehabilitation Permit Application Form Page 1 of 4 Complete if applying on behalf of a business, corporation or public agency or institution Name of business, agency, or institution Tax identification no. Description of business, agency, or institution Principal Officer Name (First, Middle, Last) Principal Officer title Primary Contact Business telephone number Alternate number Business Fax Business Email address Physical Address (Street Address, apartment #, Suite #, Room# -No PO Boxes) Mailing Address (include if different from physical address; include name of contact person if applicable) All applicants MUST complete Certification: I herby certify that I have read and am familiar with the Wildlife Rehabilitation Permit regulations and certify that the information submitted in this application for a permit is complete and accurate to the best of my knowledge and belief. I understand that any false statement herein may subject me to the criminal penalties of HRS §183D-5. Signature (in blue or black ink) of applicant/person responsible for permit Date 2008 DOFAW Wildlife Rehabilitation Permit Application Form Page 2 of 4 STATE OF HAWAII PROTECTED WILDLIFE PERMIT FOR WILDLIFE REHABILITATION Note: A State Protected Wildlife Permit for Wildlife Rehabilitation is required to keep and maintain indigenous wildlife, introduced wild birds, game birds, or game mammals in captivity for the protection, treatment for injury or disease propagation, and other similar purposes consistent with the preservation, protection, and conservation of the animals (HRS §183D- 61, HAR§13-124-4). Applicants must be at least 18 years of age and Hawaii residents. Note that you may not take possession of any protected wildlife prior to the issuance of your permit. Please provide the following information on a separate piece of paper: 1. IDENTIFY SPECIES AND NUMBER a. List the common and scientific names(s) of the species you propose to rehabilitate b. If known, provide the status (endangered (E) or threatened (T), migratory (M)) 2. EXPERIENCE a. Describe in detail your rehabilitation experience, including the amount of time spent handling and caring for each species you propose to rehabilitate. b. Provide the name, address, and telephone number of the facilities where your experience was obtained. 3. PERMANENT FACILITIES a. Describe your facilities (incubators, cages, pens, kennels, etc). Attach photographs and diagrams of your facilities and enclosures. Diagrams must include dimensions (length x width x height) and a description of the materials used for construction. Indicate the type of species that will be housed in each enclosure along with flooring and netting materials used. b. All facilities maintained for wildlife rehabilitation purposes should meet the minimum standards prescribed for such facilities by the National Wildlife Rehabilitators Association and the International Wildlife Rehabilitation Council. Furthermore, the Division may specify individual caging requirements on a case-by-case basis. Are you prepared to have your facility inspected by the Division? 4. TRANSPORTATION a. Describe how you will transport live wildlife should the need arise. What type of enclosures will you use for each species during transport? Include the dimensions of your transport enclosures (l x w x h). 5. AFFILIATIONS a. Are you affiliated with the International Wildlife Rehabilitation Council or the National Wildlife Rehabilitators Association? If so please provide your membership number. 2008 DOFAW Wildlife Rehabilitation Permit Application Form Page 3 of 4 6. DIET a. Provide a detailed description of the diet you will administer for each species and the source of the food items. 7. SUB-PERMITTEES a. Provide the full name and birthdate of anyone besides yourself who will be conducting activities under your permit. For anyone handling and caring for protected wildlife briefly describe his or her activities and qualifications. Note that anyone who will be assisting you with the permitted activities or acting as your agent either must have their own State permit for the activity or be identified by you, in writing, as a sub-permittee of your permit. b. Sub-permittees must be at least 18 years of age. As the primary permittee you will be responsible for ensuring that your sub-permittees are properly trained and that they adhere to the terms and conditions of your permit. 8. VETERINARIANS a. List the name, contact information, and address of any veterinarian licensed to practice in the State of Hawaii with whom you intend to consult with during wildlife rehabilitation activities. 9. OTHER PERMITS a. List any current permits or licenses held by you for possession of protected wildlife. Note that your State permit is not valid without proper Federal authorization for those species protected by Federal law. Federal permit coverage for you and your sub- permittees is required, and copies of all applicable Federal permits must be submitted with your application. b. Have you ever received a wildlife citation or wildlife conviction? If your answer is yes, please explain (date, location, violation, etc.). 2008 DOFAW Wildlife Rehabilitation Permit Application Form Page 4 of 4 A GUIDE TO WILDLIFE REHABILITATION IN HAWAII Injured Wedge-tailed Shearwater picked up on the East side of the island of Oahu. Hawaii Division of Forestry and Wildlife 1151 Punchbowl Street Rm. 325 Honolulu, Hawaii 96813 808.587.0166 Wildlife Rehabilitation Overview Wildlife rehabilitation is the act of providing temporary care to injured, sick, or orphaned wildlife with the goal of releasing the animal back into the wild. When an animal is admitted for rehabilitation it faces four fates: death as a result of its medical condition, successful rehabilitation, and release, permanent placement as an educational display due to factors preventing its release, or euthanasia. Successful release of wildlife means that the animal must be able to live as a healthy member of a wild population. This includes the ability to recognize and find appropriate foods, socialize and reproduce with members of its own species, and exhibit normal behaviors such as fear of humans and predator avoidance. As defined in HAR 13-124-2 “wildlife” means any member of any non-domesticated species of the animal kingdom. All indigenous wildlife, wild birds, game birds, and game mammals are protected by Hawaii State law and ownership of those animals remains with the State. Therefore, wild animals are not to be held in captivity without proper State issued permits or licenses. Anyone wishing to engage in wildlife rehabilitation in Hawaii is required to obtain a Protected Wildlife Permit from the Hawaii Division of Forestry and Wildlife. In addition, anyone wishing to rehabilitate migratory bird or those species protected by federal law must also obtain a permit from the U.S. Fish and Wildlife Service. The Hawaii Division of Forestry and Wildlife issues Protected Wildlife Permits for wildlife rehabilitation to qualified individuals over 18 years of age. The intent of a wildlife rehabilitation permit is to ensure all persons engaged in the rehabilitation of wildlife are capable of providing humane care and housing for the animals being rehabilitated. Wildlife rehabilitation can be rewarding however it is extremely demanding and consumes a large amount of time, energy, and money. Potential candidates should seriously consider the numerous responsibilities with wildlife rehabilitation before actively pursuing a permit. What is involved with Wildlife Rehabilitation? Wildlife rehabilitators must be willing to: Donate their personal time: Quality wildlife rehabilitation will take up a large amount of your personal time. For those wildlife rehabilitators caring for orphaned young expect to be feeding baby birds every 20 minutes and bottle-feeding baby mammals every couple of hours around the clock. Preparing diets, cleaning cages, and constructing new cages will take up even more time. Most experienced wildlife rehabilitators recommend that beginners spend their first year on one or two common or easier to rehabilitate species. Finding out the species’ natural history, rehabilitation recommendations, proper caging, and appropriate diet will be important. Once you feel comfortable working with that species you may want to consider your time availability and financial commitments before expanding to other species. Remember that around the clock animal care can interfere with your social and family life. How will you go on vacation when you have baby birds to feed? Having well established relationships with other local rehabilitators can help you with some of these time commitments. As you become known in the local community as a wildlife rehabilitator you should expect an increase in