Dog Registration - Delano, Minnesota

1. OWNER INFORMATION
 
* Owner's Name
 
* Street Address:
 
Mailing Address:
 
* Contact Phone Number:
 
* E-Mail Address: (Only used for questions on registration)
 
 
2. PET INFORMATION
 
* Dog's Name:
 
* Breed:
 
  Male
Female
* Color:
 
* Is your dog Spayed or Neutered:
  Yes
No
 
3. VETERINARIAN INFORMATION
 
* Veterinarian Name:
 
Address:
 
Has your dog been vaccinated for Rabies? ** Checking NO will result in denial of Dog Registration. See Code 406.01 for further information.
  Yes
No
* Rabies Vaccination Number: (If unknown - contact your veterinarian.)
 
* Rabies Vaccination Expiration: (If unknown - contact your veterinarian.)
 
 
4. MICROCHIP INFORMATION
 
* Is your dog microchipped:
  Yes
No
Chip Number:
 
Company that made the chip:
 
Enter Letters For Verification
* Required Fields