2. City of Falls Church Dog License Application
   Licenses are valid for up to 3 years and will be determined by the expiration date of the Rabies vaccination.
4. Owners Name*
6. Co-Owners Name
8. Address1*
10. Address2
12. City*
13. State*
14. Zip*
16. Phone*
17. Alternate Phone
19. Email*
21. Dog's Name*
22. Sex*

    1. Female
    2. Male
23. Spayed/Neutered?*

    1. Yes
    2. No
25. Breed*
26. Color*
28. Veterinarian Office's Name
29. Veterinarian Office Phone*
33. Rabies Vaccination Verification
    Virginia state law requires us to verify rabies vaccinations. Please mail the rabies vaccination certificate to our office, or attach it with this application. If you DO NOT have your rabies certificate, we will be happy to call and verify the information with your Veterinarian. Your Vet can fax your rabies certificate directly to us!
35. Rabies Vaccination Verification*

    Choose how you would like to submit your dog's rabies vaccination certificate:

    1. Upload Electronically (see file upload below)
    2. Send to Treasurer's Office by mail or in-person
    3. Have Treasurer's Office call my Veterinarian's Office
37. Rabies Vaccination Certificate
    Attach a virtual copy of your dog's rabies vaccination certificate if you have one.
41. Dog License Fee

    The fee for a dog license is $5 for spayed or neutered dogs or $10 for unaltered (not spayed or neutered dogs).

    
    

    Please mail check or money order (addressed to Treasurer, City of Falls Church) to

    Treasurer, City of Falls Church

    300 Park Ave.

    Suite 201W

    Falls Church, VA 22046

    
    

    You can also bring your payment to our offices in-person. To pay online, please visit http://www.fallschurchva.gov/Pay.

43. Application Payment Method*

    Choose how you would like to remit payment.

    1. Online (visit www.fallschurchva.gov/pay)
    2. By Mail
    3. In Person
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit Submit and Print

* indicates a required field