Dog License Application
Please fill out the following information. A tag will be sent to you by mail. Please attach the tag to your dog's collar. If you have any questions, please call our office at 204-324-5357 ext. 2 or email office@rhinelandmb.ca. Thank you!
Owner Information
Name
*
First Name
Last Name
Address
*
Street Address
Mailing Address
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Dog Information
Dog Information
*
Name
Gender (M/F)
(Intact/Fixed)
Age
Breed
Colour/Markings
Current Rabies (Y/N)
Tattoo#
Dog 1
Dog 2
Dog 3
Dog 4
Release of Information
I authorize the Municipality of Rhineland to release this information to enable them to contact me if/when my dog is picked up or impounded
*
Yes
E-Signature: Typing your name constitutes an electronic signature and all information provided above is correct.
*
Date
*
-
Month
-
Day
Year
Date
Dog Tag Option
Please mail me the tag(s)! (Please make sure to enter your mailing address above)
I will pick up the tag(s) at the Rhineland office at 109 3rd Ave NE, Altona.
Please upload the most recent photo of your dog!
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Dog 1
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File Upload
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Dog 2
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Dog 3
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Dog 4
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of
Submit
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