Form Center

2. 
3. LOST DOG / DOG AT LARGE
5. ***********************************************ONLY AUTHORIZED PERSONNEL*********************************************** Complete this form to report a dog at large has been picked up and dropped off to the City of Fairbury Dog Pound ***************************************************************************************************************************************
7. DATE DOG FOUND*
8. NAME OF INDIVIDUAL THAT FOUND DOG*
9. CONTACT #:*
11. ADDRESS/LOCATION WHERE DOG FOUND*
13. STATUS

    1. DOG HAS BEEN PLACED IN POUND
    2. DOG IS STILL AT LARGE
    3. DOG IS WITH CITIZEN FILING REPORT
    4. DOG HAS BEEN RETURNED TO OWNER
14. DATE & TIME DOG PLACED IN POUND
17. DETAILS OF FOUND DOG
19. BREED:*
20. COLOR:*
21. LICENSE #/RABIES TAG #:
23. APPROX AGE:*
24. APPROX WEIGHT:*
25. OTHER COMMENTS:
27. COAT:*

    1. SHORT
    2. LONG
    3. CURLY
    4. WIRY
    5. OTHER
28. TAIL:*

    1. SHORT
    2. LONG
    3. BUSHY
    4. RING
    5. OTHER
29. EARS*

    1. CROPPED
    2. DROPPING
    3. ERECT
    4. OTHER
30. COLLAR:*

    1. CHAIN
    2. LEATHER
    3. NONE
    4. OTHER
32. UPLOAD PHOTO (OPTIONAL)
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit Submit and Print

* indicates a required field