Type Full Name :
Sign With Hand
City
If Other Breed, specify
Required Documents
If you need to make your payment by mail or in person, our office is located at:
Vaccination Information
Size
Owner Information
Sex
Age
Phone #
Rabies Vaccination Exempt?
Color
{[PNAME]}
State
Phone #
  1. Current Rabies Certificate
Address 2
Mailing Address
Species
Applicant Signature
Vaccination Certificate #
First Name
Expiration Date
ZIP
City
Pay By Credit Card
Is Valid?
Pay Later
Veterinarian Information
ZIP
Residence of Dog
Last Name
Animal Name
By submitting this form, I am confirming that all of the information I have entered is accurate, according to the best of my knowledge. I understand that failure to provide correct information will result in revocation of my pet’s license.
If you'd like to pay now by Credit Card, click the Submit & Pay Now button below.
Spayed/Neutered?
Application Type
Note that payment must be received in full before a Animal License and Registration Tags can be issued.

License Fee
Vaccination Date
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
State
Email
Address
or
Animal Information
Name
Certification
Predominant Breed
Mailing Address 2
Payment Method
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
In order to receive your permit, you must first pay the above Application Fee.
Specify Address where BOTH Dog and Owner reside