Required fields are marked with asterisks (*)

Hen Coop Licence Application

Licenses expire on December 31st of the year in which it is issued. Licenses must be renewed in advance of March 1st of the following year. The fee for license renewal is $25.

Name

Address

Phone Number

E-mail Address

Date of Birth

Veterinarian Information

Name:

Contact Information (please fill in one or both)

Telephone Number:

Email Address:

Renewal Declaration

I/We, the undersigned, have reviewed the Backyard Chickens By-law and understand all associated conditions and fees and continue to abide by the provisions.

Signature of Applicant

Clear