1

Name of Nonprofit (as shown on 501c3):

 *

Name of Nonprofit (as shown on 501c3):

2

Address

 *

Address

Street

City

State

Zip

3

Please list the current head of organization’s name, email and phone number.

 *

Please list the current head of organization’s name, email and phone number.

4

Please list the names and contact information for representatives of your organization that oversee your animal records and documentation.

 *

Please list the names and contact information for representatives of your organization that oversee your animal records and documentation.

5

Please list everyone that is approved to select and tag transfer animals for your organization.

 *

Please list everyone that is approved to select and tag transfer animals for your organization.

6

What species, breeds, sizes, temperaments, medical conditions, and types of animals do you take in?

 *

What species, breeds, sizes, temperaments, medical conditions, and types of animals do you take in?

7

Who provides your veterinary services? Please list names and phone numbers.

 *

Who provides your veterinary services? Please list names and phone numbers.

8

What method of contact should OKCAWD provide to citizens interested in adopting or reclaiming animals transferred to your organization? Please include a contact name and phone number or email. (This is not optional as we are subject to open records request.)

 *

What method of contact should OKCAWD provide to citizens interested in adopting or reclaiming animals transferred to your organization? Please include a contact name and phone number or email. (This is not optional as we are subject to open records request.)

9

Our organization wishes to participate in the Pet Placement Program of the City of Oklahoma City Animal Welfare Division. We agree to abide by the policies and procedures outlined in the Transfer Program Manual and the Transfer Agreement (To be signed by a representative at time of transfer).

 *

Our organization wishes to participate in the Pet Placement Program of the City of Oklahoma City Animal Welfare Division. We agree to abide by the policies and procedures outlined in the Transfer Program Manual and the Transfer Agreement (To be signed by a representative at time of transfer).

Yes

No

10

Authorized Representative (Only include the name of the person filling out this application)

 *

Authorized Representative (Only include the name of the person filling out this application)

Print Name

Title

Date

11

Do you want to receive emails/text messages about animals in need?

 *

Do you want to receive emails/text messages about animals in need?

Yes

No

12

Please return completed form to City of OKC Animal Welfare Division Pet Placement Program by mailing to 2811 SE 29^th St., OKC, OK 73129 or emailing awtransfers@okc.gov if you are not completing it online. Please attach your 501c3 and articles of incorporation or by-laws for your application to be considered. This should include your spay/neuter process and adoption process plus all other documents relevant to your organization. 

 *

Please return completed form to City of OKC Animal Welfare Division Pet Placement Program by mailing to 2811 SE 29th St., OKC, OK 73129 or emailing awtransfers@okc.gov if you are not completing it online. Please attach your 501c3 and articles of incorporation or by-laws for your application to be considered. This should include your spay/neuter process and adoption process plus all other documents relevant to your organization.

501c3 Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

Articles of Incorporation or By-Laws Click button for uploading file Clear Maximum size allowed: 5 MB Allowed types: .gif, .jpg, .jpeg, .png, .doc, .docx, .xls, .xlsx, .rtf, .pdf, .txt

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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