2007 DOG LICENSE APPLICATION FORM

2008 DOG LICENSE APPLICATION FORM

OWNER'S NAME: PHONE #1:

PHYSICAL ADDRESS: PHONE #2:

DOG 1

DOG 2

DOG 3

DOG NAME: DOG NAME: DOG NAME:

COLOR: COLOR: COLOR:

BREED: BREED: BREED:

VET CLINIC: VET CLINIC: VET CLINIC:

LAST RABIES SHOT: LAST RABIES SHOT: LAST RABIES SHOT:

CHECK ONE:

Male $8.00
Neutered Male $3.00
Female $8.00
Spayed Female $3.00

CHECK ONE:

Male $8.00
Neutered Male $3.00
Female $8.00
Spayed Female $3.00

CHECK ONE:

Male $8.00
Neutered Male $3.00
Female $8.00
Spayed Female $3.00

Multiple Dogs $35.00 ( 12 Tags )

       You will get 12 tags with a Multiple Dog License, even if you do not have 12 dogs.

       Submit the required information for each dog; name, color, breed, vet clinic, last rabies shot, etc,
       with this application form. ( You can print multiple copies of this form if you need to )

       Dogs are not required to have a dog tag until they are 5 months old.

       If you get additional dogs after you have been issued the Multiple Licenses, attach one of your
       extra tags, then call the treasurer and give her the required information for that dog.


MAKE CHECK PAYABLE TO: TOWN OF CHASE TREASURER                                                     CHECK TOTAL

PRINT & MAIL FORM TO:       JOLENE SCHWARM, 1330 HAYWOOD LN, SOBIESKI, WI 54171         CHECK #

IF QUESTIONS, PLEASE CALL JOLENE AT (920) 822-3322.       ( TO PRINT THIS FORM, RIGHT-CLICK, THEN SELECT PRINT )

OWNER'S NAME:		PHONE #1:
PHYSICAL ADDRESS:		PHONE #2:
DOG 1	DOG 2	DOG 3
DOG NAME:	DOG NAME:	DOG NAME:
COLOR:	COLOR:	COLOR:
BREED:	BREED:	BREED:
VET CLINIC:	VET CLINIC:	VET CLINIC:
LAST RABIES SHOT:	LAST RABIES SHOT:	LAST RABIES SHOT:
CHECK ONE: Male $8.00 Neutered Male $3.00 Female $8.00 Spayed Female $3.00	CHECK ONE: Male $8.00 Neutered Male $3.00 Female $8.00 Spayed Female $3.00	CHECK ONE: Male $8.00 Neutered Male $3.00 Female $8.00 Spayed Female $3.00
Multiple Dogs $35.00 ( 12 Tags ) You will get 12 tags with a Multiple Dog License, even if you do not have 12 dogs. Submit the required information for each dog; name, color, breed, vet clinic, last rabies shot, etc, with this application form. ( You can print multiple copies of this form if you need to ) Dogs are not required to have a dog tag until they are 5 months old. If you get additional dogs after you have been issued the Multiple Licenses, attach one of your extra tags, then call the treasurer and give her the required information for that dog.
MAKE CHECK PAYABLE TO: TOWN OF CHASE TREASURER CHECK TOTAL PRINT & MAIL FORM TO: JOLENE SCHWARM, 1330 HAYWOOD LN, SOBIESKI, WI 54171 CHECK # IF QUESTIONS, PLEASE CALL JOLENE AT (920) 822-3322. ( TO PRINT THIS FORM, RIGHT-CLICK, THEN SELECT PRINT )