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2. Town Of Grand Island -Dog License Application

4. First Name*
5. Last Name*
6. Address*
8. Phone Number*
9. Email Address*
11. Dog's Name:*
12. Dog's Breed:*
13. Dog's Color*
14. Dog's Year of Birth*
16. ID/ Markings/ Micro Chip
17. Last Rabies Vaccination Date: (Current Veterinary Certification Required)*
19. Please check appropriate box:*

    1. Male, neutered
    2. Female, spayed
    3. Male, unneutered
    4. Female, unspayed

20. *If your dog is spayed or neutered, a veterinary certification is required. If unavailable, you must fill out a "Sworn statement of Spay/Neuter" found on the Town Clerks page. 

    Complete all the information, print, and send in with a check/money order, and a self-addressed stamped envelope.

22. Make checks payable to and return with a self-addressed stamped envelope:

23. Grand Island Town Clerk

    2255 Baseline Road

    Grand Island, NY 14072

24. FEES:

    $8.00- Spayed/Neutered

    $3.00-Senior (over 65)

    $16.00- Unspayed/Unneutered

    $11.00-Senior (over 65)

    
    

26. Questions? - 716-773-9699 ext. 600

27. *ALL LICENSES ARE RENEWED ANNUALLY

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28. Print Only

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