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2. Owner Information
4. First Name*
5. Last Name*
7. Phone*
8. Email*
10. Home Address*
11. Zip Code*
15. Dog Number 1
17. Dog 1 Name*
18. Dog 1 Breed & Color*
19. Dog 1 Sex & License Fee*

    1. Male (in-tact) - $15
    2. Male (neutered) - $10
    3. Female (in-tact) - $15
    4. Female (spayed) - $10
    5. Late fee (if after March 31) - $10
21. Dog 1 Date of Rabies Shot*
22. Dog 1 Rabies Shot Expiration*
23. Dog 1 Rabies Manufacturer*
25. Dog 1 Rabies Lot / Serial Number*
26. Dog 1 Rabies Shot Certificate*
30. Dog Number 2
32. Dog 2 Name
33. Dog 2 Breed & Color
34. Dog 2 Sex & License Fee

    1. Male (in-tact) - $15
    2. Male (neutered) - $10
    3. Female (in-tact) - $15
    4. Female (spayed) - $10
    5. Late fee (if after March 31) - $10
36. Dog 2 Date of Rabies Shot
37. Dog 2 Rabies Shot Expiration
38. Dog 2 Rabies Manufacturer
40. Dog 2 Rabies Lot / Serial Number
41. Dog 2 Rabies Shot Certificate
45. Dog Number 3
47. Dog 3 Name
48. Dog 3 Breed & Color
49. Dog 3 Sex & License Fee

    1. Male (in-tact) - $15
    2. Male (neutered) - $10
    3. Female (in-tact) - $15
    4. Female (spayed) - $10
    5. Late fee (if after March 31) - $10
51. Dog 3 Date of Rabies Shot
52. Dog 3 Rabies Shot Expiration
53. Dog 3 Rabies Manufacturer
55. Dog 3 Rabies Lot / Serial Number
56. Dog 3 Rabies Shot Certificate
60. Veterinarian / Clinic Information
62. Vet / Clinic Name*
63. Vet / Clinic Phone*
65. Please upload the most current rabies vaccination certificate for each dog.

67. Thank you for using our online Dog License Application. Once you click submit, you will be taken to our online payment portal (AllPaid) to pay the fees. Your application will be processed in the order it was received. Once the fee is received, the dog license tag(s) will be mailed to you.

69. Please note:  A paper license will not be sent, only the tag. The Dog License(s) are not valid without payment. You can also mail your check to: Village of Lisbon ATTN: Dog License W234N8676 Woodside Road Lisbon, WI 53089 Or you can use the drop box to the left of Village Hall's front door.

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71. 1. Receive an email copy of this form.
72. Email address

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73. Submit Submit and Print

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