Employee Status Updated: 10/18/2018 12:00 AM Normal
Office Status: Normal
Employee Information

Dog License Application

STATE LAW REQUIRES - ALL DOGS FOUR MONTHS OF AGE AND OLDER MUST BE LICENSED AND PROOF OF RABIES PRESENTED AT TIME OF APPLICATION

OWNER INFORMATION:
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
Physical Address:
City:
State:
Zip Code:
Telephone:
E-Mail:
 
DOG INFORMATION: (RABIES AND STERILIZATION CERTIFICATE MUST BE MAILED WITH APPLICATION)
DOG'S NAME:
BREED:
SEX:
STERILE?
COLOR:
BIRTH (MO/YR.):
IS THIS A RENEWAL?
DO YOU NEED A NEW DOG LICENSE TAG:
LICENSE TAG #:
RABIES VACCINATION DATES: FROM: TO:
RABIES TAG #:
MICROCHIP #: (optional)