Dog Licensing Application

Personal Assistance Dog - No Fee Required

Personal Assistance Dogs certified by the Canadian National Institute of the Blind/Hearing Impaired and registered with the Hearings of Canada and/or dogs trained as a helper for the physically disabled person or a therapy dog used in an institutional setting:

Confirmation

By checking this box and submitting this form, I confirm the following:

• I consent to the collection of my personal information included on this form, for the purpose of administering the Town of Amherstburg dog licensing program.
• That there are only a maximum of 3 dogs residing at this residential property.
• I confirm that the dog that I am registering is NOT any of the following:

Any dog of the Pit Bull, Staffordshire, Bull Terrier, American Pit Bull, American Staffordshire Terrier or Presa Canario breeds of dog;

Any hybrid dog produced from a breed mentioned in (a) above;

Any crossbreed dogs that possess substantial characteristics of one or more of the dog breeds referred to in (a) above.

*Senior rate applicable for those 55+