Dog Breeder Registration Form

Registration Year: 2025

Organization Information

*Primary Owner/Applicant Full Name:
Additional Owner(s) Name(s) (if applicable):
If any breeding dogs are co-owned, list all co-owners.
Business Name (if applicable):
*Mailing Address:
,
Breeding Facility Address (if different):
,
*Phone:
*Email:
*Preferred Contact Method:

Registration Type

*Type of Breeder:
*Are you a member of any dog breed clubs or registries?
If yes, please list:

Breeding Information

*Number of breeding dogs (Males):
*Number of breeding dogs (Females):
*Estimated Number of Puppies Sold Annually:
*List all dog breeds currently part of your breeding operation:

Animal Care & Facility Info

*Housing Location:
*Do you have a veterinary care plan for your breeding operation?:
*At what age do you allow puppies to go into their new homes? (in weeks):
*Do your puppies receive vaccines and deworming before placing in a new home?:
*Do you offer a health guarantee?:
*Do you offer a return-to-breeder policy if the dog can't be kept?:
Veterinarian's Name and Practice:

Required Document Uploads

The following documents are required:
  • Proof of rabies vaccine for all owned dogs over 3 months of age (required by ordinance)
  • Photos of the area your breeding dog(s) are primarily housed
  • Veterinary Care Plan (required by ordinance)
  • Dog Socialization and Enrichment Plan (required by ordinance)
*Select File(s) to Upload:


Acknowledgment & Signature

Acknowledgment: I certify that the information provided in this registration form is true and complete to the best of my knowledge. I further agree to comply with all applicable local, state, and federal laws and regulations pertaining to the breeding, care, and sale of dogs.
*Electronic Signature (Type Full Name):