Type Full Name :
Sign With Hand
First Name
Address 2
Phone # *
Specify Address where BOTH Dog and Owner reside *
If "Other", specify
Required Documents
State *
Sex *
Age *
If "Other", specify
Is Rabies Vaccination Exempt? *
Dog License Application
Color *
Phone # *
1.  New Registrations
     All new applicants must include a valid Rabies Certificate and Spayed/Neutered Certificate before a license can be issued.
     The Rabies Certificate must be valid through October 1st of the licensing year.
     
2.  Renewals
     Renewals must include a valid Rabies Certificate.
     The Rabies Certificate must be valid through October 1st of the licensing year.

3.  Service Dogs
     All applications for Service Dogs must include a valid Service Dog Registration Certificate.

4. Important Notice
     Please note that if your pet’s rabies is due on or before October 1st then you must provide a signed note from your vet stating that it is too
     soon to get an updated vaccine.
Borough of
New Providence
Hair Length *
Applicant Signature *
Expiration Date *
Are all required documents attached to this online application? *
Amount Due
Size *
Is Valid?
Veterinarian Information
Address *
Email
First Name *
Last Name
ZIP *
Dog's Name *
Dog Fee:   $16 if spayed/neutered
I acknowledge that all statements made herein are accurate and that this application will not be accepted as submitted until all required documents are remitted, and all applicable fees are paid.
$19 if not spayed/neutered
Phone #
Is this Application for a New Dog or Renewal? *
Is the dog Spayed/Neutered? *
A renewal license must be paid for prior to February 28th, after that a $5.00 late fee will be charged.
Email *
License Fee
Vaccination Date *
If applicable, provide details of another owner for this dog that resides at the same address.
Address *
Dog Information
Hospital Name *
Certification
Documents
Owner Information
Breed *
Last Name *
360 Elkwood Avenue
New Providence, NJ 07974
Tel: (908) 665-1400 ext.0 | Fax: (908) 665-9272
www.newprov.org
Is this a Service Dog? *
Vaccination Information
Previous License Number (if known)
City *