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.  

 

Notes:

            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.