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Dog License

2. First Name*
3. Last Name*
5. Address1*
7. Address2
9. City*
10. State*
11. Zip*
13. Dog Name*
14. Color*
15. Breed*
17. Veterinarian*
19. Male / Female
    -- Select One --Male ($15.00)Female ($15.00)Female - Spayed ($10.00)Male - Neutered ($10.00)
20. Expiration*
    Expiration
    Date Rabies vaccination expires
21. Rabies Vaccination Date*
    Rabies Vaccination Date
    Date of most recent Rabies vaccination
23. Late Fee

    1. $5.00 late fee if after April 1

    There is a $5.00 late fee if the dog license application is received on or after April 1.

24. Rabies Vaccination Certificate*
    Upload a PDF file or your dog's Rabies Vaccination Certificate
26. Next Step - choose Option 1 or Option 2
28. Option 1
    Submit this online application. After form has been submitted, send payment (include $5.00 late fee, if applicable) and self-addressed, stamped envelope to Lodi City Hall, attn: City Clerk, 130 S. Main Street, Lodi, WI 53555. Your dog license and tag will be mailed back to you in the envelope you provide.
29. Option 2
    Print this form. Hand deliver the dog application form, rabies certificate, and payment (include $5.00 late fee, if applicable) to City Hall, 130 S. Main Street, Lodi, WI 53555. Dog license will be processed while you wait.
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field