Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Current Membership *

Are you currently a member of the Turtle Conservancy? Members receive priority and additional benefits.

Yes, I am currently a member of the Turtle Conservancy.

No, I do not currently hold a membership with the Turtle Conservancy.

Requested animals *

Please select the species you have a serious interest in acquiring for breeding and conservation purposes. *Please note that Radiated Tortoises and Indian Spotted Pond Turtles are listed on the Endangered Species Act, so they are available for adoption by California residents or holders of a current captive-bred wildlife (CBW) permit issued by the US Fish and Wildlife Service.

Burmese Black Mountain Tortoise (Manouria emys phayrei)

Burmese Star Tortoise (Geochelone platynota)

Radiated Tortoise (Astrochelys radiata) *

Spiny Hill Turtle (Heosemys spinosa)

Indian Spotted Pond Turtle (Geoclemys hamiltonii)*

Veterinarian's Contact Information *

Please provide information to your veterinarian. (Must have experience with chelonians or ability to access someone who has experience.)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Photo request policy *

Please acknowledge that you are aware we cannot provide pictures for individual photo requests of animals. We provide photos that are representative of each species and adopt out animals that meet our standards of health and aesthetics. We understand this is disappointing to some people, but the labor and time saved is needed for our conservation efforts and enables us to adopt healthy animals to interested parties much more efficiently. Your participation in our adoptions program aides us in providing care for our animals and for our conservation programs abroad. We will not entertain photo requests at this time, sorry.

I accept that I will not be able to request photos of individual animals, and acknowledge that the Turtle Conservancy will provide photographs that are representative of each species and will adopt out healthy animals that meet our high aesthetic standards. Your participation in our adoption program aides us in focusing our efforts on international conservation programs and providing the best possible care for the animals in our assurance colonies.

Legal Background *

Have you or your affiliates ever been fined, indicted, or convicted by any government agency regarding the care, welfare, acquisition, or retention of animals housed by you or your facility?

No

Yes (If yes, please include an explanation with associated documents.)

Verification and Right of First Refusal *

By clicking this box, I attest that the accompanying statements are true and complete. By submitting this form you also agree to provide annual status reports upon request, and to give the right of first refusal on future transfer of animals provided to you by the Turtle Conservancy.