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2. Important Information

4. Before Proceeding: This form does not allow for electronical/online payments. You will need to submit payment separately. 

   
   

   This form is only required for new dogs, you do not need to complete for a renewal. 

   
   

   The majority of this information is required, if not filled in or selected the form will not be submitted properly.

   
   

   Your dog is not considered 'registered' until payment is received and processed. You may submit payment in person, via mail, or by phone with a credit card. All card transactions accrue a 2.5% surcharge fee.

   
   

   If you're looking to register your dog online through the State of Maine Animal Welfare website you need to do so through their website: https://www.maine.gov/dacf/ahw/animal_welfare/doglicense/index.shtml

   
   

   
   

   Please complete the following information and provide a current Rabies Certificate for each dog. The rabies certificate will be labeled 'Rabies Certificate'. Please do not upload a shot record, or vet visit summary we cannot accept those as proof of rabies vaccination. 

   
   

   Please also provide proof of spay or neuter (if applicable) for each dog. 

   
   

   If you have questions please call or email the Town Clerk's office at (207) 725-6658, option 4, or clerks@brunswickme.org.

   
   

   • Spayed/Neutered Dog Fee: $6.00
   • Intact Dog Fee: $11.00
   • State set Late Fee takes effect February 1st: $25.00
6. Check if you have read and understand the above statement*

   1. Read
   2. Not Read
8. Primary Owner Contact
10. First Name*
11. Last Name*
13. Street Address*
15. Mailing Address*
17. Phone Number*
18. Email Address*
22. Dog Information
24. Dog's Name*
26. Primary Breed*
27. Secondary Breed (If Applicable)
29. Purebred

    1. Purebred

    Please check if dog is purebred

31. Date of Birth (estimate if unknown)
32. Age (estimate if unknown)*
34. Gender*

    1. Male

    1. Female
35. Spayed or Neutered*

    1. Spayed
    2. Neutered

    1. Intact

    Must provide proof of spayed or neutering, please upload at the end of this form.  

37. Animal Size*

    1. Small

    1. Medium

    1. Large

    1. Extra Large
39. Primary Color*

    1. Apricot
    2. Beige
    3. Black
    4. Blonde
    5. Blue
    6. Blue Black
    7. Brindle
    8. Bronze
    9. Brown
    10. Buff
    11. Butterscotch

    1. Charcoal
    2. Chestnut
    3. Chocolate
    4. Copper
    5. Cream
    6. Ebony
    7. Fawn
    8. Golden
    9. Green
    10. Grey
    11. Lavender

    1. Lilac
    2. Liver
    3. Lynx
    4. Mahogany
    5. Mustard
    6. Orange
    7. Pink
    8. Red
    9. Rust
    10. Sable
    11. Sandy

    1. Seal
    2. Shaded Cream
    3. Silver
    4. Silver Black
    5. Smoke
    6. Tan
    7. Taupe
    8. Wheaten
    9. White
    10. Yellow

    If the dog has a secondary color, please select below. 

41. Secondary Color

    1. Apricot
    2. Beige
    3. Black
    4. Blonde
    5. Blue
    6. Blue Black
    7. Brindle
    8. Bronze
    9. Brown
    10. Buff
    11. Butterscotch

    1. Charcoal
    2. Chestnut
    3. Chocolate
    4. Copper
    5. Cream
    6. Ebony
    7. Fawn
    8. Golden
    9. Green
    10. Grey
    11. Lavender

    1. Lilac
    2. Liver
    3. Lynx
    4. Mahogany
    5. Mustard
    6. Orange
    7. Pink
    8. Red
    9. Rust
    10. Sable
    11. Sandy

    1. Seal
    2. Shaded Cream
    3. Silver
    4. Silver Black
    5. Smoke
    6. Tan
    7. Taupe
    8. Wheaten
    9. White
    10. Yellow
43. Color Pattern*

    1. Aqouti
    2. Badger
    3. Bi-Color
    4. Brindle
    5. Calico
    6. Dapple

    1. Dilute
    2. Harlequin
    3. Marble
    4. Merle
    5. Mitted
    6. Point

    1. Roan
    2. Salt & Pepper
    3. Solid
    4. Spotted
    5. Tabby

    1. Tick
    2. Tiger
    3. Tricolor
    4. Tuxedo
    5. Van
45. Rabies Certificate Information
47. Rabies Tag #*
48. Rabies Expiration Date*
50. Administering Veterinarian*

    The veterinarian who issued the shot. 

51. Veterinarian Phone Number*
53. Uploads

    A Rabies Certificate is required for each dog. It must be a Rabies Certificate and not a shot record or visit summary. The Rabies Certificate will be labeled 'Rabies Certificate'.

    If your dog is spayed or neutered and it is not indicated on the Rabies Certificate, please upload proof of Spay and Neuter. 

55. Upload Rabies Certificate*

    A Rabies Certificate will be labeled as such, please do not upload a shot record. 

56. Upload Spay or Neuter Information

    If applicable

60. Payment Information

62. We CANNOT accept payment through this form. Please indicate how you anticipate payment. 

64. I plan to submit payment:*

    1. By Mail (Check or Money Order)

    1. In-Person

    1. By Telephone
66. By Mail

    Please make checks/money orders payable to ‘Town of Brunswick’ and mail to: Town Clerk’s Office, 85 Union Street, Brunswick, ME 04011.

    Indicate your name as well as the dogs name in the envelope.

67. If telephone, please include a phone number for us to reach you.

    We will contact you once we have processed your registration form and ready for payment. 

69. Notes:

    Any additional notes.

71. If you have additional dogs, please resubmit this form with their information, or you may use the PDF fillable/printable form on our website.

Leave This Blank:


73. 1. Receive an email copy of this form.
74. Email address

    This field is not part of the form submission.

75. Submit

* indicates a required field