Rescue/Transfer Partner Questionnaire

Organization Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Format: (000) 000-0000.

E-mail*

example@example.com

Primary Contact for Rescue/Shelter

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Secondary Contact for Rescue/Shelter

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

What animals does your rescue or shelter accept*

If Other, please specify

Physical ShelterKennel or Boarding FacilityFoster Homes until AdoptionOther

If you have a physical shelter, what is the number of animals the shelter can house and what is the square footage of the shelter?

If you are primarily a foster based rescue, what is the maximum number of animals you will allow in a foster home?

If you are a purebred rescue, do you accept breed mixes?:

If you are a mixed breed rescue, what size or breeds do you primarily accept?:

Does your rescue or shelter spay and neuter prior to adoption?

If no, please explain

Unweaned kittens(age 0-3 weeks, requires bottle feeding)Intermittent Bottle Babies (age 4-6 weeks)Toddler stage of kittens (age 6-8 weeks with intermittent bottle feedingsNursing mother with kittens (age 0-8 weeks)Kittens (age 2-5 months)Adolescent (age 6-11 months)Adults (age 1-7 years)Senior (age 8-12 years)Super Senior (age 13+ years)

Unweaned puppies(ages 0-5 weeks, requires bottle feeding)Toddler stage of puppies (ages 6-8 weeks with intermittent bottle feedingsNursing mother with puppies (ages 0-8 weeks)Adult DogsSenior dogs (8 years and up)

What are the requirements for people to foster for your rescue or shelter:

If you accept behavior cases, please list types of behavior cases you accept and how you handle those cases:

*We reserve the right to place animals based on public safety and liability and to use discretion when working with animals with history of aggression and biting, regardless of capacity of rescue organization or shelter.

If you accept behavior cases, please list trainers and behavioral support you provide for your adopters and fosters:

What types of medical and behavior cases do you not accept:

Please list what circumstances your organization selects euthanasia for an animal in your care:

Please list the veterinary clinics who provide care for your organization:

Rows	Clinic Name	Address	Contact Number	Services provided
1
2
3

Please provide the following statistical information for the last 2 full years of your organization.

Rows	Intakes	Adoptions	Euthanasias	Year
1
2

How many animals are currently in your care?

What is your average length of stay of animals in your care?

Thank you for submitting your application to partner with Fort Wayne Animal Care and Control. Please remember applications will be reviewed within the week of receiving them. We ask that only designated rescue/shelter team members contact us directly, to ensure communication remains efficient.