Dog License Form

Kindly select 'Yes' to continue if you are a resident of Philadelphia.*

Yes

Name:*

First NameLast Name

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Is this a renewal?*

YesNo

Animal Sex*

Neutered MaleNon-neutered maleSpayed FemaleNon-Spayed Female

Dog's Name*

Animal Age (in years) *

Breed, Colors, and Markings *

Is the dog a service animal required because of a disability?

YesNo

What work or task has the dog been trained to perform?

Does your dog have a current rabies vaccine?*

YesNo

What veterinary office gave your dog's most recent rabies vaccine? *

Rabies Tag Number*

Proof of vaccination*

See attachedPlease contact my veterinarian

File Upload

My Products

Spayed / Neutered License

Please choose this selection if your dog has been spayed or neutered.

$16.00

Spayed / Neutered License (Senior Citizen 65+)

Please choose this selection if your dog has been spayed or neutered.

$8.00

Non-Spayed / Non-Neutered License

Please choose this option if your dog has not been spayed or neutered.

$40.00

Non-Spayed / Non-Neutered License (Senior Citizen 65+)

Please choose this option if your dog has not been spayed or neutered.

$20.00

Service Dog License

Please choose this option if your dog is a service animal required because of a disability.

$ Free

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Philadelphia Dog License Form

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