Transfer Partner Information

Transfer Partner Information
Thank you for your interest in partnering with the Wake County Animal Center! Please provide the following information to get started.
A copy of your 501(c)(3) paperwork*

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Your signed Transfer Partner Agreement*

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Copies of your adoption and foster contract/agreement (if applicable)

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A copy of your registration with the Department of Agriculture (if applicable)

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Organization Name*
Address*

Street Address

Street Address Line 2

CityState

ZIP Code
Phone*
Please enter a valid phone number.
Fax
Please enter a valid phone number.
Email*
example@example.com
Website*
Organization President or Director

This person has authorization to enter into an agreement with the Wake County Animal Center (WCAC) for the purpose of transferring animals under the Transfer Partnership Agreement and represent our organization on the Wake County Transfer Partner Facebook Page.
President/Director Name*

First NameLast Name
Facebook Name (if different)
Primary Phone*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Email*
example@example.com
Is the Director/President also the primary contact for transferring animals from WCAC?*

YesNo
Primary Contact

This person has authorization to enter into an agreement with the WCAC for the purpose of transferring animals under the Transfer Partnership Agreement and represent our organization on the Wake County Transfer Partner Facebook Page.
Name*

First NameLast Name
Facebook Name (if different)
Primary Phone*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Email*
example@example.com
Authorized Pullers

Authorized pullers may enter into an agreement with the Wake County Animal Center WCAC for the purpose of transferring animals under the Transfer Partnership Agreement and represent our organization on the Wake County Transfer Partner Facebook Page. There is a maximum of 3.
Are there additional people who would be authorized to enter into an agreement with WCAC for the purpose of transferring animals under the Transfer Partnership Agreement and represent the organization on the Wake County Transfer Partner Facebook Page?*

YesNo
Authorized Puller 1
Name

First NameLast Name
Facebook Name (if different)
Phone
Please enter a valid phone number.
Email
example@example.com
Authorized Puller 2
Name

First NameLast Name
Facebook Name (if different)
Phone
Please enter a valid phone number.
Email
example@example.com
Authorized Puller 3
Name

First NameLast Name
Facebook Name (if different)
Phone
Please enter a valid phone number.
Email
example@example.com
Professional References
Please list three shelters that your organization currently works with that can provide a reference.
Shelter Name
Contact Name

First NameLast Name
Phone
Please enter a valid phone number.
Email
example@example.com
Shelter Name
Contact Name

First NameLast Name
Phone
Please enter a valid phone number.
Email
example@example.com
Shelter Name
Contact Name

First NameLast Name
Phone
Please enter a valid phone number.
Email
example@example.com
Veterinarian/Medical Information
Veterinarian or Clinic Name*
Address*

Street Address

Street Address Line 2

CityState

ZIP Code
Phone*
Please enter a valid phone number.
Do you have the following on staff at your organization?

VeterinarianRegistered Veterinary Technician
Does your organization mandate spaying/neutering of adopted pets?*

YesNoWe are a sanctuary and do not adopt out animals.
Are animals (cats/dogs) altered prior to adoption?*

YesNo
Our organization is interested in these medical cases:

Orthopedic cases and post-opEmaciated/refeedingCage-rest recoveries (ex. pelvic fracture)Animals needing wheelchairsAllergic dermatitisChronic illness (ex. Addison's)Other
General Information
Our organization is interested in transferring the following types of animals:*

DogsPoultryPuppiesPigsCatsGoatsKittensHorses/DonkeysLittle Critters (small mammals other than dogs and cats)SheepBirdsLlamas/AlpacasNon-Mammalian ExoticsCows
If your organization is breed-specific, please specify the breed and if they must be purebred or may be mixed.
Our organization is interested in animals:*

with medical issueswith behavioral issuesin need of hospice carefrom cruelty casesthat are medically and behaviorally appropriate for adoption
Our animals are housed in:*

an NCDA inspected shelterfoster homesboarding facilitiesan inspected shelter in another state (please list below)
Does your organization have a behavioral modification program?*

YesNo
Please describe your behavioral modification program, including the types of behaviors addressed. If you do not have a behavioral modification program, how do you generally address behavioral issues that arise?*
Our organization is interested in these behavioral cases:

Leash ReactivityExtensive Socialization (dog)Barrier Reactivity (dog)Bite History (not severe)Inter-Species AggressionFear-Based AggressionExtensive Socialization (cat)Food AggressionLitter Box Issues (cat)
Please verify that you are human*
Should be Empty:

Transfer Partner Information

Organization President or Director

Primary Contact

Authorized Pullers

Authorized Puller 1

Authorized Puller 2

Authorized Puller 3

Professional References

Veterinarian/Medical Information

General Information