Dog License Application

C$0

Total
In accordance with Animal Control By-law 2019-109, every owner of a dog shall:

1. Register the dog with the Town and pay an annual license and registration fee;
2. Renew such license and registration annually no later than January 31st of each year;
3. Obtain a replacement tag in the event that such tag is lost;
4. Notify the Town of any change in information provided in the license application form;
5. Ensure that the dog wears the current license issued for the dog at all times while off the owner's property;
6. Provide to the Town the following information:
- name, address, telephone number of the dog owner;
- name, age, gender, breed, and colour of the dog;
- proof of sterilization from a qualified veterinarian, if required; and
- proof of a microchip implant, if applicable.
7. Ensure that the dog is duly immunized against rabies and that the immunization is current;
8. Keep no more than three dogs at any time; and
9. Not give false information when applying for a license.

Fees:

Dog (Intact) $35.00
Dog (Spayed or Neutered) $30.00
Dangerous Dog– please apply in person at the Town’s Administration Office (100 Dissette Street, Unit 7 & 8)

All licenses purchased between November 1 & January 31 will receive a $5.00 discount.
Acknowledgement

Acknowledgement I have read and acknowledge the above conditions and agree the below information provided is true and correct.
Owner Information
Name Name First Last
Email
Street Number
Street Name (start typing street name to locate)
Street Name (OLD)
Unit/Apartment/PO Box
Postal Code
Town
Telephone Telephone - ### - ### ####
Dog 1 Information
Dog's Name
Breed
Animal Colour
Gender
Age (Years) (if dog is less than 1 year old, enter 0 here)
Age (Months)
Spayed/Neutered
Rabies Vaccination
Rabies Vaccination Number
Rabies Expiry Date Rabies Expiry Date / MM / DD YYYY
Microchipped
Veterinary Clinic
Additional Dog (2)

Additional Dog (2) Add a second pet
Dog 2 Information

If applicable, please fill in the information below for an additional dog (max three per dwelling).
Dog's Name
Breed
Animal Colour
Gender
Age (Years) (if dog is less than 1 year old, enter 0 here)
Age (Months)
Spayed/Neutered
Rabies Vaccination
Rabies Vaccination Number
Rabies Expiry Date Rabies Expiry Date / MM / DD YYYY
Microchipped
Veterinary Clinic
Additional Dog (3)

Additional Dog (3) add a third pet
Dog 3 Information

If applicable, please fill in the information below for an additional dog (max three per dwelling).
Dog's Name
Breed
Animal Colour
Gender
Age (Years) (if dog is less than 1 year old, enter 0 here)
Age (Months)
Spayed/Neutered
Rabies Vaccination
Rabies Vaccination Number
Rabies Expiry Date Rabies Expiry Date / MM / DD YYYY
Microchipped
Veterinary Clinic
Draw your signature into the box below.

Draw or Type

I acknowledge that by completing and submitting this form electronically that the Town of Bradford West Gwillimbury is accepting my electronic signature and that the electronic signature will be the legally binding equivalent of my handwritten signature for the purpose of submitting this form to the Town. Clear

Full Name

I acknowledge that by completing and submitting this form electronically that the Town of Bradford West Gwillimbury is accepting my electronic signature and that the electronic signature will be the legally binding equivalent of my handwritten signature for the purpose of submitting this form to the Town.
Date Date / MM / DD YYYY
Notice of Collection

The personal information collected on this form is collected under authority of By-law 2019-109. This information will be used to license pets, to administer the animal license program and for by-law enforcement. Questions about the collection of personal information for this program should be directed to the Licensing Officer at 905-775-5366 ext. 1102.
Administration Section

To be filled out by Enforcement Staff after form has been submitted.
Dog 1 Tag Number
Dog Tag 1 Dog Name
Dog 1 Tag Issued By
Dog 1 Tag Date Issued Dog 1 Tag Date Issued / MM / DD YYYY
Dog 2 Tag Number
Dog Tag 2 Dog Name
Dog 2 Tag Issued By
Dog 2 Tag Date Issued Dog 2 Tag Date Issued / MM / DD YYYY
Dog 3 Tag Number
Dog Tag 3 Dog Name
Dog 3 Tag Issued By
Dog 3 Tag Issued Date Dog 3 Tag Issued Date / MM / DD YYYY
C$0

Total

Dog License Application

C$`0`

Total

In accordance with Animal Control By-law 2019-109, every owner of a dog shall:

Owner Information

Dog 1 Information

Dog 2 Information

Dog 3 Information

Notice of Collection

Administration Section

C$`0`

Total

Dog License Application

C$0

Total

In accordance with Animal Control By-law 2019-109, every owner of a dog shall:

Owner Information

Dog 1 Information

Dog 2 Information

Dog 3 Information

Notice of Collection

Administration Section

C$0

Total

C$`0`

C$`0`