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_________