City of Brockton Dog License Application
* ALL FIELDS MUST BE FILLED IN COMPLETELY
Dog Licenses are good from May 1st until April 30th.
Date: ___________________
*Owners Name: __________________________________________
*Address: ___________________________________________
___________________________________________
*Telephone: ___________________________________________
*Name of Dog: ___________________________________________ *Age: ___________________
*Breed of Dog: ___________________________________________ *Color: ___________________
*Gender: Male – Neutered $10.00 Fee
Male – Non-Neutered $24.00 Fee
Female – Spayed $10.00 Fee
Female – Non-Spayed $24.00 Fee
Please fill out and print this form and mail it along with a current rabies certificate** and payment to:
Elections Commission
City Hall
45 School St.
Brockton, MA 02301
** - If your rabies certificate does not include Spayed/Neutering information please include
documentation.
