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Dog License Application
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This form has been modified since it was saved. Please review all fields before submitting.
Name (First & Last)
*
Phone
*
Number of Dogs
*
-- Select One --
1
2
3
4
Address (location where dogs are kept)
*
City
State
Zip
Fees
There is a $0.50 charge to mail your dog tags to you (to cover postage & supplies). It is $0.50 whether you have 1 or 4 dogs. If you do not wish to pay the mailing cost, you will need to stop at Village Hall to pick up your dog license. Licensing fees for each dog are listed in the "Sex Type" dropdown menu. Before you click "Submit", please make sure you know the total owed, as you will need to enter it on the credit card processing site. Example: You need to license two dogs, one female and one neutered male. The total fees would be $23.50 ($0.50 mailing + $15 female + $8 neutered male)
Individual Dog Information
All information below is required for each dog. Submissions with missing information will not be processed. If you are submitting information on a new dog, or a dog with an updated Rabies Certificate, you must be able to scan the Rabies Certificate to be able to complete your application online. If you cannot scan, you may provide the Rabies Certificate by dropping off or faxing (565-4879) a copy to Village Hall.
Dog #1 - Name
Dog #1 - Color(s)
Dog #1 - Breed
Dog #1 - Sex Type
-- Select One --
Female - $15
Spayed Female - $8
Male - $15
Neutered Male - $8
Veterinarian (Business Name)
Rabies Certificate
Please attach the Rabies Certificate, not the invoice showing payment for rabies vaccination.
Dog #2 - Name
Dog #2 - Color(s)
Dog #2 - Breed
Dog #2 - Sex Type
-- Select One --
Female - $15
Spayed Female - $8
Male - $15
Neuetered Male - $8
Veterinarian (Business Name)
Rabies Certificate
Please attach the Rabies Certificate, not the invoice showing payment for rabies vaccination.
Dog #3 - Name
Dog #3 - Color(s)
Dog #3 - Breed
Dog #3 - Sex Type
-- Select One --
Female - $15
Spayed Female - $8
Male - $15
Neutered Male - $8
Veterinarian (Business Name)
Rabies Certificate
Please attach the Rabies Certificate, not the invoice showing payment for rabies vaccination.
Dog #4 - Name
Dog #4 - Color(s)
Dog #4 - Breed
Dog #4 - Sex Type
-- Select One --
Female - $15
Spayed Female - $8
Male - $15
Neutered Male - $8
Veterinarian (Business Name)
Rabies Certificate
Please attach the Rabies Certificate, not the invoice showing payment for rabies vaccination.
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