Dog License Order Form

Purchase Dog License for dog in Clackamas County, Oregon.

Fill out the form below to purchase a dog license. If you would like to renew a license please use the Renew License form. Bold fields are required.

Discounts:

• $5 off a year if your dog is microchipped and you provide a microchip number.
• 25% off per year if your dog is certified Canine Good Citizen (this discount must be obtained in person at the shelter)

If you live within the limits of the Cities of Lake Oswego or Happy Valley, you will need to obtain a license for your dog from your local City.

CONTACT INFORMATION

First Name:
Last Name:
Address:
Mailing Address:
City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code:
Phone Number:
Emergency Number:
Email:

DOG INFORMATION

Dog's Name:
Age/Birthdate
Breed:	Unknown DogAffenpinscherAfghan HoundAiredale TerrierAkitaAlaskan MalamuteCocker SpanielMiniature American EskimoAmerican EskimoToy American EskimoAmerican FoxhoundAmerican Pit Bull TerrierAmerican Staffordshire TerrierAmerican Water SpanielAmerican White ShepherdAnatolian Shepherd DogAustralian Cattle DogAustralian KelpieAustralian ShepherdAustralian TerrierBasenjiBasset HoundBeagleBeagle HarrierBearded CollieBedlington TerrierBelgian ShepherdBernese Mountain DogBichon FriseBlack and Tan CoonhoundBloodhoundBlue HeelerBorder CollieBorder TerrierBorzoiBoston TerrierBouvier des FlandersBoxerBriardBrittany SpanielBrussels GriffonBull TerrierMiniature Bull TerrierBulldogBullmastiffCairn TerrierCatahoula BulldogCavalier King Charles SpanielChesapeake Bay RetrieverChihuahuaChinese CrestedChow ChowClumber SpanielCocker SpanielCollieCorgiCurly-Coated RetrieverDachshundDalmatianDandie Dinmont TerrierDoberman PinscherElkhoundEnglish BulldogEnglish Cocker SpanielEnglish CoonhoundEnglish FoxhoundEnglish PointerEnglish SetterEnglish Springer SpanielEnglish Toy SpanielField SpanielFinnish SpitzFlat-Coated RetrieverFox TerrierFoxhoundFrench BulldogGerman ShepherdGerman Shorthaired PointerGerman Wirehaired PointerGiant SchnauzerGlen of Imaal TerrierGolden RetrieverGordon SetterGreat DaneGreat PyreneesGreater Swiss Mountain DogGreyhoundHarrierHavaneseHoundHuskyIbizan HoundIrish TerrierIrish SetterIrish Water SpanielIrish WolfhoundItalian GreyhoundJack Russell TerrierJapanese SpanielJapanese SpitzKeeshondKelpieKerry Blue TerrierKing Charles SpanielKomondorKuvaszLabrador RetrieverLakeland TerrierLhasa ApsoMalteseManchester TerrierMastiffMiniature American EskimoMiniature Bull TerrierMiniature DachshundMiniature PinscherMiniature PoodleMiniature SchnauzerNewfoundlandNorwegian LundehundNorfolk TerrierNorwegian ElkhoundNorwich TerrierOld English SheepdogOtterhoundPapillonPekingesePharaoh HoundPit BullPinscherPointerPomeranianMiniature PoodleStandard PoodleToy PoodlePortuguese Water DogPugPuliRat TerrierRed HeelerRetrieverRhodesian RidgebackRottweilerRough CollieSaint BernardSalukiSamoyedSchipperkeSchnauzerScottish DeerhoundScottish TerrierSealyham TerrierShar-PeiSheepdogShepherdShetland SheepdogShiba InuShih-TzuShiloh ShepherdSiberian HuskySilky TerrierSkye TerrierSmooth CollieSoft Coated Wheaten TerrierSpanish Water DogSpitzSpringer SpanielStandard PoodleStandard SchnauzerSussex SpanielTerrierTibetan MastiffTibetan SpanielTibetan TerrierToy American EskimoToy Fox TerrierToy PoodleVizslaWeimaranerWelsh Corgi-PembrokeWelsh Corgi-CardiganWelsh Springer SpanielWelsh TerrierWest Highland White TerrierWhippetWirehaired Pointing GriffonWolf HybredXoloYorkshire TerrierOther
Second Breed	Purebred Mixed Other Unknown DogAffenpinscherAfghan HoundAiredale TerrierAkitaAlaskan MalamuteCocker SpanielMiniature American EskimoAmerican EskimoToy American EskimoAmerican FoxhoundAmerican Pit Bull TerrierAmerican Staffordshire TerrierAmerican Water SpanielAmerican White ShepherdAnatolian Shepherd DogAustralian Cattle DogAustralian KelpieAustralian ShepherdAustralian TerrierBasenjiBasset HoundBeagleBeagle HarrierBearded CollieBedlington TerrierBelgian ShepherdBernese Mountain DogBichon FriseBlack and Tan CoonhoundBloodhoundBlue HeelerBorder CollieBorder TerrierBorzoiBoston TerrierBouvier des FlandersBoxerBriardBrittany SpanielBrussels GriffonBull TerrierMiniature Bull TerrierBulldogBullmastiffCairn TerrierCatahoula BulldogCavalier King Charles SpanielChesapeake Bay RetrieverChihuahuaChinese CrestedChow ChowClumber SpanielCocker SpanielCollieCorgiCurly-Coated RetrieverDachshundDalmatianDandie Dinmont TerrierDoberman PinscherElkhoundEnglish BulldogEnglish Cocker SpanielEnglish CoonhoundEnglish FoxhoundEnglish PointerEnglish SetterEnglish Springer SpanielEnglish Toy SpanielField SpanielFinnish SpitzFlat-Coated RetrieverFox TerrierFoxhoundFrench BulldogGerman ShepherdGerman Shorthaired PointerGerman Wirehaired PointerGiant SchnauzerGlen of Imaal TerrierGolden RetrieverGordon SetterGreat DaneGreat PyreneesGreater Swiss Mountain DogGreyhoundHarrierHavaneseHoundHuskyIbizan HoundIrish TerrierIrish SetterIrish Water SpanielIrish WolfhoundItalian GreyhoundJack Russell TerrierJapanese SpanielJapanese SpitzKeeshondKelpieKerry Blue TerrierKing Charles SpanielKomondorKuvaszLabrador RetrieverLakeland TerrierLhasa ApsoMalteseManchester TerrierMastiffMiniature American EskimoMiniature Bull TerrierMiniature DachshundMiniature PinscherMiniature PoodleMiniature SchnauzerNewfoundlandNorwegian LundehundNorfolk TerrierNorwegian ElkhoundNorwich TerrierOld English SheepdogOtterhoundPapillonPekingesePharaoh HoundPit BullPinscherPointerPomeranianMiniature PoodleStandard PoodleToy PoodlePortuguese Water DogPugPuliRat TerrierRed HeelerRetrieverRhodesian RidgebackRottweilerRough CollieSaint BernardSalukiSamoyedSchipperkeSchnauzerScottish DeerhoundScottish TerrierSealyham TerrierShar-PeiSheepdogShepherdShetland SheepdogShiba InuShih-TzuShiloh ShepherdSiberian HuskySilky TerrierSkye TerrierSmooth CollieSoft Coated Wheaten TerrierSpanish Water DogSpitzSpringer SpanielStandard PoodleStandard SchnauzerSussex SpanielTerrierTibetan MastiffTibetan SpanielTibetan TerrierToy American EskimoToy Fox TerrierToy PoodleVizslaWeimaranerWelsh Corgi-PembrokeWelsh Corgi-CardiganWelsh Springer SpanielWelsh TerrierWest Highland White TerrierWhippetWirehaired Pointing GriffonWolf HybredXoloYorkshire TerrierOther
Dog Color/Markings:
Dog Weight:
Dog Gender:	Male   Female
Is Dog Spayed/Neutered?:	Yes   No
How long have you owned this dog?:
Microchipped?:	Yes   No
Microchip #:	* To apply for $5 discount per year, a microchip # must be provided.
Veterinary Name:	*vet where rabies vaccinations and spay/neuter was given
Dog Owners Name Vet has on file:	*vet where rabies vaccinations and spay/neuter was given
Veterinary Phone:
Rabies Expiration:
Please fax (503) 557-2829 or email (dogservices@co.clackamas.or.us) a copy of your rabies vaccination certificate.