Type Full Name :
Sign With Hand
Last Name
City
If Other Breed, specify
Required Documents
Vaccination Information
Size *
Owner Information
Sex *
Age *
Phone # *
Rabies Vaccination Exempt? *
Color *
{[PNAME]}
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 31st of the licensing year.

2. Renewals
Renewals must include a valid Rabies Certificate.
The Rabies Certificate must be valid through October 31st of the licensing year.

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

Address *
Hair Length *
Applicant Signature *
First Name *
Expiration Date *
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
ZIP
{[CNAME]}
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? *
The fee for this application will be calculated upon approval. You will receive a request for payment by email.
Payments may be made by:
1) Credit Card online (details will be in the body of the email)
2) Check or money order by mail
3) Credit card, cash, or money order in-person.
License Fee
Vaccination Date *
State
Email *
Full Address *
Dog Information
How do you intend to pay? *
Name *
Certification
Breed *
Address 2
Service Dog? *
Email
Previous License Number (if known)
Specify Address where BOTH Dog and Owner reside *
Application Type