Not Renewed Renewed

New Renewal

Short Medium Long

Small Medium Large

Male Female

No Yes

No Hearing Ear Seeing Eye Service Dog

No Yes

No Yes Exempt

Last Name

City

If Other Breed, specify

Required Documents

Vaccination Information

Size *

Owner Information

Sex *

Age *

Phone # *

Rabies Vaccination Exempt? *

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 April 30th of the licensing year.

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

Address *

Application Type

Hair Length *

Applicant Signature *

First Name *

Expiration Date *

ZIP

First Name

Is Valid?

If applicable, provide details of another owner for this dog that resides at the same address.

Veterinarian Information

Last Name *

Dog Name *

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. I acknowledge that if no payment is made within seventy two (72) hours of this application, it will be deemed null and void, and I will be required to make a new application.

Phone #

Spayed/Neutered? *

Note that payment must be received in full before a Dog License and Registration Tags can be issued.

A renewal license must be paid for prior to March 16th, after that a $10.00 late fee will be charged.

License Fee

Vaccination Date *

State

Email *

Full Address

Dog Information

Name

Certification

Breed *

Address 2

Service Dog? *

Email

Previous License Number (if known)

Specify Address where BOTH Dog and Owner reside - enter Street Number and Name (Ex: 123 main) and press Enter to Search *