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Albury Council LGA - Subsidised Dog Vaccination Application

Applicant's Full Name

*

Phone Number

*

Email Address

*

Residential Address

*

Dog's Name

*

Dog's Age (in years)

*

Dog's Breed

*

Dog's Sex

*

A

Male

B

Female

C

Unknown

If you have a litter of puppies or multiple dogs, please list the details of your animals below (amount of puppies, any names and details)

*

Does your dog(s) have any vaccination history?

*

A

Yes

B

No

C

Unsure

Please detail any vaccination history you are aware of.

*

Is your dog Microchipped?

*

A

Yes

B

No

C

Unsure

Is your microchip registered to the council?

*

A

Yes

B

No

C

Unsure

Are the details on your microchip up to date?

*

A

Yes

B

No

C

Unsure

Albury council is providing FREE microchipping services on this day. If this is a service you require for your dog, please complete the section below.

*

A

Yes

B

No

Please list the Albury LGA Suburb you reside in?

*

Select which option below best matches your current situation

*

Pensioner

Veteran

Upload Evidence of Eligibility

*

If approved for the subsidised vaccination, you will be allocated an appointment time. The vet check and vaccination will take 15mins. If there are multiple dogs, more time will need to be allocated

*

8am-10am

11am-1pm

2pm-5pm

By signing below, I confirm that the information provided in this application is true and correct to the best of my knowledge.

*

Signature