2. Monroe Police Department Rescue Group Application

4. Name of Group*
6. Main Point of Contact*
8. Address*
9. City*
10. Zip Code*
12. Phone Number*
13. Email Address*
15. Website
16. Preferred Method of Contact*

    1. Email
    2. Phone
18. Please provide contact information for all additional representatives from your group. Include a name, address, phone number, and email address for each person.*
20. Designated Representative*
21. Primary Representative*
23. Please attach a copy of the organization's Federal 501c3 non-profit paperwork.*
25. Please attach a copy of the organization's mission statement.*
27. Please attach a copy of the organization's adoption requirements and contract.*
29. Enter any other pertinent information which may help Monroe Police Department understand your organization's procedures.
31. How long has this group been organized? *
33. How many volunteers and fosters do you currently utilize? *
35. What are your requirements/limitations of transferring an animal?*
37. How does your group house rescued animals? Check all that apply. *

    1. Foster Homes
    2. Vet Offices
    3. Group Facility
    4. Outside Kennel Structure
    5. Other
38. If you chose other, please elaborate. What vets does your group utilize? Include hospital name, address, and phone number for each one.
40. Will your group accept animals with medical problems?*

    1. Yes
    2. No
41. Does your group or fosters operate within a residential community? *

    1. Yes
    2. No
43. What's the group's policy on animals that have bitten a person?*
45. What is your group's policy on animals that have displayed animal aggression?*
47. Please provide any other information that you would like to share about the group.
49. Monroe Police Department Rescue Partner Agreement

    The following stipulations and guidelines are set forth and agreed upon by the undersigned rescue partner and the Monroe Police Department Animal Care and Control Division (MPDACCD). For the purposes of G.S. 19A-23(5b), written standards for an "approved rescue organization" shall include but not be limited to: the application process; sanitation protocols; provision of daily observation of the animals; feeding and watering protocols; provision and documentation of veterinary care of the shelter's animals; provision and documentation of human and same-species daily interaction, exercise, play and environmental enrichment for the shelter's animals in long term care at the rescue; requirements for inspection by the shelter; and compliance by the rescue with the North Carolina Animal Welfare Act and its rules issued pursuant thereto.

    1. MPDACCD agrees to designate a representative who will act as the liaison for the rescue partner’s representatives should an animal meeting the rescue partner’s standard come into the guardianship of MPDACCD. The MPDACCD employee will place the rescue partner’s name on an Interested Party (IP) memo on the animal record at the rescue partner’s request in person, by phone, or by email.
    2. MPDACCD agrees to provide to the rescue partner any information regarding the animal’s health and temperament given to MPDACCD by the previous owner, or as determined by the MPDACCD staff: 
       • MPDACCD cannot guarantee the health or behavior of any animal. Rescue partners indemnify and hold Monroe Police Department Animal Care & Control Division and the City of Monroe free and harmless from all liability arising out of any and all claims, demands, losses, damages, action, judgment of every kind and description which may occur to or be suffered by me, members of my household, or any third parties by reason of activities arising out of this agreement.
    3. MPDACCD agrees to waive fees for rescue partner transfers.
    4. Rescue partners may “pre-adopt” animals at no charge. This may be completed in person or via email. The rescue partner understands that any pre-adopted animals must complete their legal hold time at the shelter. The rescue partner understands an owner may reclaim that animal. If an owner reclaims the animal, the rescue partner will be notified via email or phone. If the animal is not reclaimed, the animal will be transferred to the rescue partner once legal hold is completed.
    5. MPDACCD will make every effort to work with the rescue partner if they need time to make arrangements to find a foster home for the animal. However, the rescue partner understands that MPDACCD may not be able to hold an animal should space, the animal’s health, or any other issue take precedence. MPDACCD retains the sole authority to determine the availability of any animal.
    6. The rescue partner will provide to MPDACCD a copy of its Federal 501(c)(3) non-profit documentation from the U.S. Department of Treasury, as well as a list of designated representatives.
    7. If the rescue partner pulls an animal requiring additional medical evaluation or treatment, the rescue partner agrees to seek veterinary treatment for the animal at their own expense and will not seek reimbursement from MPDACCD or the City of Monroe.
    8. Only pre-approved rescue partner members will be authorized to pull animals from MPDACCD.
    9. MPDACCD retains the authority to deny an adoption to any rescue partner at any time. An explanation will be provided to the rescue partner.
    10. This agreement may be reviewed and/or revised at any time at the discretion of MPDACCD, and notification of the revised policy will be sent to all rescue partner organizations.
    11. Either party may, without cause, terminate this agreement at any time.

    The undersigned representative entered in this field hereby agrees upon these conditions:

51. First Name*
52. Last Name*
54. Code of Conduct Agreement

    The purpose of this Code of Conduct agreement is to promote effective understanding and collaboration among Monroe Police Department Animal Care & Control (MPDACCD) and our Rescue Partners. Our vision for this collaboration is to ensure a home for every healthy and treatable companion animal.

    Commitments:

    • We are committed to the belief that no one organization or type of organization can solve the pet overpopulation crisis on their own. The only solution is for all rescue partners to work together.
    • We agree to hold mutual respect for one another. We will work collectively to improve the welfare of animals in our community.
    • Confidentiality in communications, when agreed upon, should always be respected.
    • Public or social media allegations, complaints, or insults will not be tolerated. Any concerns involving MPDACCD shall be directed solely to the Rescue Partner Coordinator.
    • Everyone will conduct him/herself in a responsible and professional manner and will address any issues or concerns directly with the relevant individuals and/or agencies with diplomacy, tact, respect, and direct communications. 
    • Working to help animals often invokes strong and passionate feelings and beliefs. Disagreements can and do erupt. The mission of this Code of Conduct agreement is to urge cooperation and collaboration among involved individuals and agencies. We strongly urge members to avoid critical attacks between individuals or groups. 

    The undersigned representative entered in this field hereby agrees upon these conditions: 

56. First Name*
57. Last Name*
59. By signing and submitting this document, you agree that all signatures where required may be Electronically Signed by either party, pursuant to NCGS 66-315(b).*

    1. I understand
61. eSignature*

    By typing my full name, I agree to use this field as my signature.

Leave This Blank:


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit

* indicates a required field