Animal License Registration

2. Owner Information

4. Name(s)*

6. Address*

7. Zip Code*

9. Phone Number*

10. Email Address

14. Animal Information

16. Name

18. Breed

20. Rabies Tag Number:

21. Rabies Vaccination Date:
    Rabies Vaccination Date:

23. Rabies Certification*

    Rabies certiciation must be received before animal licensing is considered complete. Please let us know how we will be receiving your copy of rabies certificate:

    1. E-mail
    2. Fax (316-744-3739)

    1. Drop off at City Hall
    2. Attaching certificate below
25. Rabies Vaccination Certificate

    Attach a copy of your most recent rabies vaccination

29. Payment Information*

    PAYMENT INFO: There is no fee for neutered and spayed dogs. To make payment for unneutered or unspayed dogs, please call 744-2451. Registrations that require payment will not be complete until payment is received.

    1. NO FEE for Neutered / Spayed
    2. $50 Unneutered / Unspayed
    3. $10 Additional Fee After March 1
    4. $3 Replacement License Tag Fee
33. Receipt Number

Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field