Application for an Avicultural (Avian) Keeper Licence

Licence covers the keeping of avian fauna at the address stated on the licence.

Completed forms should be returned to:
Dept of Biodiversity, Conservation and Attractions
17 Dick Perry Avenue, Kensington or post to:
Locked Bag 30, Bentley Delivery Centre WA 6983
Or faxed to (08) 9219 8242 or emailed. / Further information on the licensing requirements is available from:
Wildlife Licensing Section
Phone: (08) 9219 9835
Email:

AVICULTURE LICENCES ARE ISSUED FOR A 1-YEAR PERIOD, WITH FEES PAYABLE AS BELOW.

PLEASE ALLOW FIVE (5) WORKING DAYS TO PROCESS COMPLETE AND CORRECT APPLICATIONS.

Applicant

Surname
Dr/Mr/Mrs/Miss/Ms / Other names
Address (residential)
Postcode
Address (postal)
Postcode
Aviary Address
Postcode
Phone / Fax / Email
Mobile / Date of birth
Signature / Date of application

Applicant is required to provide:

1 proof of identity and age (driver’s licence, passport, or other appropriate document).

2 copy of Senior’s Card discount eligibility must be provided once. With no copy of card presented FULL fee must be paid.

3 details of any relevant convictions in Australia in the past five (5) years. Relevant conviction means a wildlife related offence.

FEES and PAYMENT:

Licence Type (tick one only)

Avicultural Licence (1 year)Fee $10Senior’s Fee $5enclosed

Advanced Avicultural Licence (1 year)Fee $30Senior’s Fee $15enclosed

Payment Type

CASH (enclosed) CHEQUE / MONEY ORDER (enclosed) CREDIT CARD (details below)

Money order/cheques made payable toDepartment of Biodiversity, Conservation and Attractions (“DBCA”) to be attached to completed application form.

*Any details below will be detached and destroyed once payment is processed. Please print clearly

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Department of Environment and Conservation

EXEMPT FROM LICENSING / No licence required if these are the only birds you hold
Budgerygah (Budgie)
Cockatiel or Weero
Chestnut-breasted Mannikin
King Quail / Diamond Dove
Peaceful Dove / Banded (Double-bar) Finch
Long-tailed (Blackheart) Finch
Star Finch
Zebra Finch

Please indicate the number of each species held.

Only list birds currentlyheld. Please do not include intended acquisitions.

AVICULTURAL / No licence required to keep or dispose if you hold a total of less than 10 of these birds
Avicultural Licence required if you hold atotal of 10 or moreof these birds
No. / No. / No.
Bourke’s Parrot / Scarlet-Chested Parrot / Masked Finch
Turquoise Parrot / Pictorella Mannikin
AVICULTURAL / No licence required to keep or dispose if you hold a total of less than 4 of thesebirds
Avicultural Licence required if you hold atotal of 4 or moreof these birds
No. / No. / No.
Sulphur-crested Cockatoo / Long-Billed Corella (Central West) / Western Rosella
Galah / Long-Billed Corella (Eastern) / Red-capped Parrot (WA King)
Little Corella / Port Lincoln Ringneck (incl. 28)
AVICULTURAL / Avicultural Licence required if you hold any number of the birds in this box
(Also covers any birds in sections above)
No. / No. / No.
Stubble Quail / Musk Lorikeet / Hooded Parrot
Brown Quail / Little Lorikeet / Mulga Parrot
Red-Backed Button-quail / Alexandra’s (Princess) Parrot / Red-rumped Parrot
Red-chested Button-quail / Regent (Smoker) Parrot / Red-vented Blue Bonnet
Painted Button-quail / Superb Parrot (Barraband) / Yellow-vented Blue Bonnet
Little Button-quail / Red-winged Parrot / Plum-headed Finch
Bar-shouldered Dove / Australian (Eastern) King Parrot / Diamond Firetail
Green-winged Pigeon / Mallee Ringneck / Painted Firetail
Common Bronzewing / Blue-winged Parrot / Red-browed Firetail
Crested Pigeon / Elegant Parrot / Gouldian Finch
Squatter Pigeon / Adelaide Rosella / Blue-faced Finch
Partridge Pigeon / Pale-headed Rosella / Yellow-rumped Mannikin
Scaly-breasted Lorikeet / Crimson Rosella / Crimson Finch
Rainbow Lorikeet / Eastern Rosella / Black-throated Finch (Parsons)
Red-collared Lorikeet / Yellow Rosella
ADVANCED
AVICULTURAL / Advanced Avicultural Licence required if you hold any number of the birds listed below
(Also covers any birds in sections above)
No. / No. / No.
Spinifex (Red-plumed) Pigeon / Yellow-tailed Black Cockatoo / Green Rosella
Brush Bronzewing / Red-tailed Black Cockatoo / Northern Rosella
Major Mitchell (Pink) Cockatoo / Eclectus Parrot / Cloncurry parrot
Gang-gang Cockatoo / Purple-crowned Lorikeet / Naretha (Little) Blue Bonnet
Baudin’s Black Cockatoo / Varied Lorikeet / Golden-shouldered Parrot
Carnaby’s Black Cockatoo / Swift Parrot / Rock Parrot
OTHER AUSTRALIAN BIRDS – Held but not included in any of the above lists
No. / No. / Exotic birds / No.
European Goldfinch
Java Sparrow

 PERMIT TO KEEP RESTRICTED BIRDS ALSO REQUIRED FOR THESE TWO (2) SPECIES

Department of Environment and Conservation