Maddie's Data Collection Grant
MONTHLY REPORTING FORM
Adoption Guarantee Organizations
YEAR: 2009
  NAME OF ORGANIZATION: Annual
    Dog Cat Total
A BEGINNING SHELTER COUNT   106 106
         
  INTAKE (Live Dogs & Cats Only)      
  From the Public      
  Healthy 0 78 78
  Treatable - Rehabilitatable 0 101 101
  Treatable - Manageable 0 7 7
  Unhealthy & Untreatable 0 4 4
B Subtotal Intake from the Public 0 190 190
  Incoming Transfers from Organizations within Community/Coalition      
  Healthy 0 1 1
  Treatable - Rehabilitatable 0 9 9
  Treatable - Manageable 0 2 2
  Unhealthy & Untreatable 0 0 0
C Subtotal Intake from Incoming Transfers from Orgs within Community/Coalition 0 12 12
  Incoming Transfers from Organizations outside Community/Coalition      
  Healthy 0 11 11
  Treatable - Rehabilitatable 0 15 15
  Treatable - Manageable 0 0 0
  Unhealthy & Untreatable 0 0 0
D Subtotal Intake from Incoming Transfers from Orgs outside Community/Coalition 0 26 26
  From Owners/Guardians Requesting Euthanasia      
  Healthy 0 0 0
  Treatable - Rehabilitatable 0 7 7
  Treatable - Manageable 0 0 0
  Unhealthy & Untreatable 0 0 0
E Subtotal Intake from Owners/Guardians Requesting Euthanasia 0 7 7
F Total Intake [B + C + D + E] 0 235 235
G Owner/Guardian Requested Euthanasia (Unhealthy & Untreatable Only) 0 0 0
H ADJUSTED TOTAL INTAKE [F minus G] 0 235 235
         
  ADOPTIONS (only dogs and cats adopted by the public)      
  Involving Dogs and Cats from Animal Control and Traditional Shelters      
  Healthy 0 68 68
  Treatable - Rehabilitatable 0 26 26
  Treatable - Manageable 0 0 0
  Unhealthy & Untreatable 0 1 1
  Subtotal Adoptions Involving Dogs and Cats from Animal Control 0 95 95
  Involving Dogs and Cats From the Public and Other Organizations      
  Healthy 0 87 87
  Treatable - Rehabilitatable 0 26 26
  Treatable - Manageable 0 2 2
  Unhealthy & Untreatable 0 0 0
  Subtotal Adoptions Involving Dogs and Cats From the Public and Other Organizations 0 115 115
I TOTAL ADOPTIONS 0 210 210
         
  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 0 0 0
  Treatable - Manageable 0 0 0
  Unhealthy & Untreatable 0 0 0
K TOTAL OUTGOING TRANSFERS to Orgs outside Community/Coalition 0 0 0
         
L RETURN TO OWNER/GUARDIAN 0 0 0
         
  DOGS & CATS EUTHANIZED      
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) 0 15 15
Q Total Euthanasia [M + N + O + P] 0 15 15
R Owner/Guardian Requested Euthanasia (Unhealthy & Untreatable Only) 0 0 0
S ADJUSTED TOTAL EUTHANASIA [Q minus R] 0 15 15
         
T SUBTOTAL OUTCOMES [I + J + K + L + S] Excludes Owner/Guardian Requested Euthanasia (Unhealthy & Untreatable Only) 0 225 225
         
U DIED OR LOST IN SHELTER/CARE 0 5 5
         
V TOTAL OUTCOMES [T + U] Excludes Owner/Guardian Requested Euthanasia (Unhealthy & Untreatable Only) 0 230 230
         
W ENDING SHELTER COUNT   109 109
In a perfect world, the Ending Count is equal to the Beginning Count (A) plus Total Intake (F) minus all Outcomes (R+V). -------> 0 111 111
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
Comments:
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 Categories"
Signature: ______Susan Burlingame____________________________________ Date: ______1/2/10_________