Required fields are marked with asterisks (*)

First Time Dog License Application Form

Please use this form for new applications only.

***Please use the Dog License Renewal System to renew a dog license.***

Type:

New License

Replacement Tag

DOG IDENTIFIERS

Dog's Name:

Year of Birth:

Breed:

Color(s):

Microchip #:

Markings:

OWNER'S INFORMATION

Last Name:

First Name:

Mailing Address:

Physical Address:

Phone:

Email:

RABIES VACCINATION

All dogs four and a half months or older must be licensed, please provide proof of current rabies vaccination and proof of neutering / spaying certificate signed by a licensed veterinarian.

Animal Hospital:

Date Vaccinated:

Manufacturer:

Serial Number:

Expiration Date (1, 2, or 3 years):

FEES

Type of License Requested:

Replacement Tag - $3.00

Neutered Male - $15.00

Spayed Female - $15.00

Unneutered Male - $20.00

Unspayed Female - $20.00

Exempt - None

First Time Dog License Application Form

DOG IDENTIFIERS

OWNER'S INFORMATION

RABIES VACCINATION

FEES

Please verify you are human: