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2. Date*
4. First Name*
5. Last Name*
7. Secondary Owner (if applicable)
9. Email Address*
11. Home Address*
13. Mailing Address*
15. City
16. Province
17. Postal Code
19. City*
20. Province*
21. Postal Code*
23. Phone Number*
24. Cell/Alternative Number*
26. Type of Dog*
27. Dog Gender*

    1. Male
    2. Female
29. Physical Description of Dog*
31. Name of Dog*
33. Has dog been spayed or neutered?*

    1. Yes
    2. No

    If Yes please attach proof.
34. Upload Supporting Documentation
36. Please note you can setup an online bill payment through your bank in order to pay for dog registration, we do not accept e-transfer. If you are having trouble setting up the payee, please contact your banking institution and they can add this to your online banking or direct you on how we are setup in their system.
    Payment can be made by cheque to Town of Slave Lake Box 1030 Slave Lake AB T0G 2A0, or through online banking. Add payee Slave Lake (Town)-AR Account number is ZZZ001
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38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit Submit and Print

* indicates a required field