Dog License

2. First Name*

3. Last Name*

5. Address1*

7. Address2

9. City*

10. State*

11. Zip*

13. Dog Name*

14. Color*

16. Veterinarian*

18. Male / Female
    -- Select One --Male ($15.00)Female ($15.00)Female - Spayed ($10.00)Male - Neutered ($10.00)

19. Expiration*
    Expiration

    Date Rabies vaccination expires

20. Rabies Vaccination Date*
    Rabies Vaccination Date

    Date of most recent Rabies vaccination

22. Late Fee

    1. $5.00 late fee if after 4/1/2018

    If dog license application is received on or after 4/1/2018, there is a $5.00 late fee.

23. Rabies Vaccination Certificate*

    Upload a PDF file or your dog's Rabies Vaccination Certificate

25. Next Step - choose Option 1 or Option 2

27. 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.

    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.

28. 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.

    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:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field