Dog Licenses

2. First Name*

3. Last Name*

5. Facebook Name*

   Will only be used to send you a message via Facebook if we think we are holding your pet.

7. Home Number*

8. Cell Phone

   Including your cell phone number gives us permission to contact you via text if we think we have your pet. Standard text messages may apply from your wireless provider.

10. Address*

11. Email Address*

13. City*

14. State*

15. Zip Code*

17. Pet's Name*

18. Type of Pet*
    -- Select One --CatDog

20. Breed*

    Example: Boxer, Bull Dog, Mixed (best guess)

21. Color*

    Examples: White, Black, Brown, Brindle, Spotted

23. Altered or Unaltered*
    -- Select One --Altered $10.00 Fee per petUnaltered $20.00 Fee per pet

    Altered = spayed/neuter Unaltered= no spay/neuter

24. Spay or Neuter Record*

25. Vaccination Records*

27. License Tag #

    For Office Use Only

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field