1

Organization Name

Organization Name

2

Addresss

Addresss

Street

City

State

Zip

3

Please list your board members, officers and their email addresses

Please list your board members, officers and their email addresses

4

Who is responsible for documentation/records of animals? 

Who is responsible for documentation/records of animals?

5

What is their phone number and email address?

What is their phone number and email address?

6

Please list everyone that is allowed to choose animals for your organization from our shelter?

Please list everyone that is allowed to choose animals for your organization from our shelter?

7

What species, breeds, size, etc. of animals do you receive?

What species, breeds, size, etc. of animals do you receive?

8

What health issues and temperaments are you willing to deal with?

What health issues and temperaments are you willing to deal with?

9

Where will the transferred animals be housed (include types of facilities and cities located)?

Where will the transferred animals be housed (include types of facilities and cities located)?

10

Who provides your veterinary services (Please list name, address and phone number)?

Who provides your veterinary services (Please list name, address and phone number)?

11

Do you screen adopter’s? List any placement procedures.

Do you screen adopter’s? List any placement procedures.

12

 Attach any adoption contracts, home visit forms, etc.

Attach any adoption contracts, home visit forms, etc. Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

13

What is included in your adoption package (cost, veterinary services, training, etc.)?

What is included in your adoption package (cost, veterinary services, training, etc.)?

14

What methods do you use to find homes for transferred animals? Include any websites. 

What methods do you use to find homes for transferred animals? Include any websites.

15

What method of contact should OKCAWD provide to citizens? Please include a contact name and phone number or email.

What method of contact should OKCAWD provide to citizens? Please include a contact name and phone number or email.

16

Our organization wishes to participate in the Pet Placement Program of the City of Oklahoma City Animal Welfare Division. We agree to abide by the policies and procedures outlined in the Transfer Program Manual and the Transfer Agreement (To be signed by a representative at time of transfer). 

Our organization wishes to participate in the Pet Placement Program of the City of Oklahoma City Animal Welfare Division. We agree to abide by the policies and procedures outlined in the Transfer Program Manual and the Transfer Agreement (To be signed by a representative at time of transfer).

Yes

No

17

Name of authorized representative filling out this application.

Name of authorized representative filling out this application.

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