Medford Township Clerk’s Office

Dog License Form

17 North Main Street

Medford, New Jersey 08055



** This form is for new dogs and new residents.


Name of Dog:             ________________________________________________


Owner Name:             ________________________________________________


Owner Address:         ________________________________________________



Phone Number:          (       )          -           


Sex of Dog:                 Male                                        Female

Age:                             _______ years

Breed:                         _________________________________________________

Hair Color:                 _________________________________________________

Hair Length:               Short                           Medium                                    Long

Is the dog Spayed or Neutered?                   Yes                              No

Rabies Expiration Date:  ______________________________________________

Veterinarian’s Name: _________________________________________________


Fees:                                       Prior to Jan. 31st                                               After Jan. 31st


Spayed or Neutered                             $12.00                                                      $27.00

Not Spayed or Neutered                      $15.00                                                      $30.00


**New dogs and new residents do not get charged late fees.  



            1.  Make checks payable to “Township of Medford

2.  You must provide proof of rabies vaccination valid through November 1st of

      the current year along with proof of spaying/neutering.

3.      If mailing, don’t forget to include a self addressed, stamped envelope.