Owner's Name (required) Owner's Address (required) Is mailing address the same as physical address? YesNo Owner's Mailing Address (if different) Home Phone (required) Other Phone Email Address (required) PET 1 INFORMATION ********************************* First Pet Pet's Name (required) CatDog (Note: Cat registration is only required in the City of Ferndale) Select Sex (required) —Please choose an option—MaleFemale Breed (required) *Indicate mix if not full breed* Color (required) Date of Birth or estimated age (required) Is your pet spayed or neutered? —Please choose an option—YesNo Sterilization was performed at: Name of Hospital Date of procedure Is your pet micro-chipped? —Please choose an option—YesNo Microchip Number Microchip Company Does this pet have current rabies vaccination? —Please choose an option—YesNo Name of Clinic Date of Vaccination Expiration Date Upload copy of rabies certificate(s). (if available) Must be pdf, txt, gif, png, jpg or jpeg ****************************** Add Next Pet —Please choose an option—YesNo Pet #2 Second Pet's Name (required) CatDog (Note: Cat registration is only required in the City of Ferndale) Breed *Indicate mix if not full breed* (required) Color (required) Date of Birth or Estimated Age (required) Select Sex (required) —Please choose an option—MaleFemale Is this pet spayed or neutered? —Please choose an option—YesNo Sterilization was performed at: Name of Hospital Date of procedure Is your pet micro-chipped? —Please choose an option—YesNo Microchip Number Microchip Company Does this pet have current rabies vaccination? —Please choose an option—YesNo Name of Clinic Date of Vaccination Expiration Date Upload copy of rabies vaccination (if available) Must be pdf, txt, gif, png, jpg or jpeg ****************************** LICENSING & REGISTRATION ****************************** Late Registration —Please choose an option—Yes $10.00No Select Pet 1 Registration Type —Please choose an option—Altered Dog $11.00Non-Altered Dog $41.00Altered Cat $11.00Non-Altered Cat $41.00 New or Renewal License (required) NewRenewal New or Lost Tag Replacement needed? (required) YesNo Select Pet 2 Registration Type —Please choose an option—Altered Dog $11.00Non-Altered Dog $41.00Altered Cat $11.00Non-Altered Cat $41.00 New or Renewal License (required) NewRenewal New or Lost Tag Replacement needed? (required) YesNo *License Contracts will be mailed unless otherwise requested. Please allow 1 to 2 weeks for receipt of license contracts due to processing time. Δ
