Test Dog Form – Boone County Conservation District

Owner Information

Owner Last Name*

Owner First Name*

Owner Middle Name*

Address*

Street Address City State ZIP Code

Are you a Boone County Resident?*

Yes
No

Phone*

Email*

Enter Email Confirm Email

How did you hear about us?

Emergency Contact

Name*

First Last

Relationship*

Phone*

FULL SEASON TAG (January – December):
$35 ($45 non-resident): $15 additional dog

HALF SEASON TAG (July – December):
$20 ($25 non-resident); $10 additional dog

ONE-DAY POOCH PASS:
$3 for one dog, $1 for each additional dog

Dog(s)

Dog #1

Name*

Breed*

Age*

Sex*

Male
Female

Spayed/Neutered?*

Yes
No

Current Rabies Tag #*

County*

Add another Dog?*

Yes
No

Dog #2

Name*

Breed*

Age*

Sex*

Male
Female

Spayed/Neutered?*

Yes
No

Current Rabies Tag #*

County*

Add a third dog?

Yes
No

Dog #3

Name*

Breed*

Age*

Sex*

Male
Female

Spayed/Neutered?*

Yes
No

Current Rabies Tag #*

County*

Tag Type*

Full Season (Jan-Dec)
Half Season (July - Dec)
One Day Pooch Pass

Date the Pooch Pass Will Be Used*

License Fees

Price:

Would you like your tag(s) mailed? There's a $1.50 charge to cover postage. If you answer no to this question, you'll need to pick up your tag(s) at the office, no earlier than 10am the next business day to allow time for processing.

Yes
No

Half Season Tags will be mailed or may be picked up no earlier than the last week of June.

Postage Fee

Price:

Credit Card Processing Fee

Price: $0.00

Total

$0.00

By typing my name and date below, I signify that I have read and agree to the WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK here

My Signature*

Today's Date*

Hammertime Dog Permit

Owner Information

Emergency Contact

Dog(s)

Dog #1

Dog #2

Dog #3

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