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*

17. City License Tag Number*

    Use the last three numbers as the account number when paying online after submitting form.

18. Age*

    Please use Months or Years with the number provided.

20. Breed*

21. Color*

22. Sex*

    1. Male
    2. Female

24. Rabies Tag Number:*

25. Rabies Vaccination Date:*
    Rabies Vaccination Date:

27. Rabies Vaccination Certificate*

    Attach a copy of your most recent rabies vaccination

29. Veterinary Clinic:*

30. Veterinary Phone Number:

34. Payment Information*

    IMPORTANT INFO: Enter the last three numbers on your dog tag as the account number when you pay online after submitting this form.

    1. $10 Neutered / Spayed
    2. $50 Unneutered / Unspayed
    3. $10 Additional Fee After March 1
    4. $3 Replacement License Tag Fee
38. Receipt Number

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field