| MONTHLY REPORTING FORM |
| Adoption Guarantee
Organizations |
| Baseline Year:
2009 |
|
|
NAME OF ORGANIZATION:
|
Annual, Jan 09 -Dec 09 |
||
|
|
|
Dog |
Cat |
Total |
|
A |
BEGINNING SHELTER COUNT
|
64 |
0 |
64 |
|
|
|
|
|
|
|
|
INTAKE (Live Dogs &
Cats Only) |
|
|
|
|
|
From the Public |
|
|
|
|
|
Healthy |
7 |
0 |
7 |
|
|
Treatable – Rehabilitatable |
4 |
0 |
4 |
|
|
Treatable – Manageable
|
0 |
0 |
0 |
|
|
Unhealthy & Untreatable
|
0 |
0 |
0 |
|
B |
Subtotal Intake from the
Public |
11 |
0 |
11 |
|
|
Incoming Transfers from
Organizations within Community/Coalition |
|
|
|
|
|
Healthy |
2 |
0 |
2 |
|
|
Treatable – Rehabilitatable |
1 |
0 |
1 |
|
|
Treatable – Manageable
|
1 |
0 |
1 |
|
|
Unhealthy & Untreatable
|
0 |
0 |
0 |
|
C |
Subtotal Intake from Incoming
Transfers from Orgs within Community/Coalition |
4 |
0 |
4 |
|
|
Incoming Transfers from
Organizations outside Community/Coalition |
|
|
|
|
|
Healthy |
11 |
0 |
11 |
|
|
Treatable – Rehabilitatable |
15 |
0 |
15 |
|
|
Treatable – Manageable
|
7 |
0 |
7 |
|
|
Unhealthy & Untreatable
|
0 |
0 |
0 |
|
D |
Subtotal Intake from Incoming
Transfers from Orgs outside Community/Coalition |
33 |
0 |
33 |
|
|
From Owners/Guardians
Requesting Euthanasia |
|
|
|
|
|
Healthy |
0 |
0 |
0 |
|
|
Treatable – Rehabilitatable |
0 |
0 |
0 |
|
|
Treatable – Manageable
|
0 |
0 |
0 |
|
|
Unhealthy & Untreatable
|
0 |
0 |
0 |
|
E |
Subtotal Intake from Owners/Guardians
Requesting Euthanasia |
0 |
0 |
0 |
|
F |
Total Intake [B + C +
D + E] |
48 |
0 |
48 |
|
G |
Owner/Guardian
Requested Euthanasia (Unhealthy & Untreatable Only) |
0 |
0 |
0 |
|
H |
ADJUSTED TOTAL INTAKE
[F minus G] |
48 |
0 |
48 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
ADOPTIONS (only dogs and
cats adopted by the public) |
|
|
|
|
|
Involving Dogs and Cats
from Animal Control and Traditional Shelters |
|
|
|
|
|
Healthy |
11 |
0 |
11 |
|
|
Treatable – Rehabilitatable |
12 |
0 |
12 |
|
|
Treatable – Manageable
|
6 |
0 |
6 |
|
|
Unhealthy & Untreatable
|
0 |
0 |
0 |
|
|
Subtotal Adoptions Involving
Dogs and Cats from Animal Control |
29 |
0 |
29 |
|
|
Involving Dogs and Cats
From the Public and Other Organizations |
|
|
|
|
|
Healthy |
5 |
0 |
5 |
|
|
Treatable – Rehabilitatable |
0 |
0 |
0 |
|
|
Treatable – Manageable
|
0 |
0 |
0 |
|
|
Unhealthy & Untreatable
|
0 |
0 |
0 |
|
|
Subtotal Adoptions Involving
Dogs and Cats From the Public and Other Organizations |
5 |
0 |
5 |
|
I |
TOTAL ADOPTIONS |
34 |
0 |
34 |
|
|
|
|
|
|
|
|
OUTGOING TRANSFERS to
Organizations within Community/Coalition |
|
|
|
|
|
Healthy |
0 |
0 |
0 |
|
|
Treatable – Rehabilitatable |
0 |
0 |
0 |
|
|
Treatable – Manageable
|
0 |
0 |
0 |
|
|
Unhealthy & Untreatable
|
0 |
0 |
0 |
|
J |
TOTAL OUTGOING TRANSFERS
to Orgs within Community/Coalition |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
OUTGOING TRANSFERS to
Organizations outside Community/Coalition |
|
|
|
|
|
Healthy |
0 |
0 |
0 |
|
|
Treatable – Rehabilitatable |
1 |
0 |
1 |
|
|
Treatable – Manageable
|
0 |
0 |
0 |
|
|
Unhealthy & Untreatable
|
0 |
0 |
0 |
|
K |
TOTAL OUTGOING TRANSFERS
to Orgs outside Community/Coalition |
1 |
0 |
1 |
|
|
|
|
|
|
|
L |
RETURN TO OWNER/GUARDIAN
|
0 |
0 |
0 |
|
|
|
|
|
|
|
L(1) |
RETURN TO HABITAT (Community/feral
cats) |
0 |
0 |
0 |
|
|
|
|
|
|
|
|
DOGS & |
|
|
|
|
M |
Healthy (Includes Owner/Guardian
Requested Euthanasia) |
0 |
0 |
0 |
|
N |
Treatable – Rehabilitatable (Includes Owner/Guardian Requested Euthanasia)
|
0 |
0 |
0 |
|
O |
Treatable – Manageable
(Includes Owner/Guardian Requested Euthanasia) |
0 |
0 |
0 |
|
P |
Unhealthy & Untreatable
(Includes Owner/Guardian Requested Euthanasia) |
10 |
0 |
10 |
|
R |
Total Euthanasia [M + N +
O + P + Q] |
10 |
0 |
10 |
|
S |
Owner/Guardian
Requested Euthanasia (Unhealthy & Untreatable Only) |
0 |
0 |
0 |
|
T |
ADJUSTED TOTAL EUTHANASIA
[R minus S] |
10 |
0 |
10 |
|
|
|
|
|
|
|
U |
SUBTOTAL OUTCOMES [I +
J + K + L + T] Excludes Owner/Guardian Requested Euthanasia (Unhealthy
& Untreatable Only) |
45 |
0 |
45 |
|
|
|
|
|
|
|
V |
DIED OR LOST IN SHELTER/ |
0 |
0 |
0 |
|
|
|
|
|
|
|
W |
TOTAL OUTCOMES [U + V]
Excludes Owner/Guardian Requested Euthanasia (Unhealthy & Untreatable
Only) |
45 |
0 |
45 |
|
|
|
|
|
|
|
X |
ENDING SHELTER COUNT |
67 |
0 |
67 |
| In a perfect world, the Ending Count is equal to the Beginning Count (A) plus Total Intake |
| (F) minus all Outcomes (S+V). -------> 67 0 67 |
|
If your reported
Ending Count does not match these numbers, please go back through your
data and be sure you didn't miss something (i.e., animals in foster, adoptions,
transfers, etc.). If all animals have been accounted for and the reported
Ending Count is different, please indicate in the comment section. Comments:
See Transfer
Tab/Sheets for details on sections C, D, J and / or K. I agree that in completing this form,
we have used the Maddie's Fund definitions of
“Healthy,” “Treatable Manageable,” “Treatable
-Rehabilitatable,” and “Unhealthy
& Untreatable” as set forth in the attached document titled,
“Maddie’s Fund® Categorizations/Definitions
of Shelter Animals.” Signature:
________________________________________________________ Date: ____________________ |