Application for a licence to breed dogs

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Use this form to apply for a licence to breed dogs

Animals to be accommodated

Applicant details

Correspondence details

Premises to be licensed

Address of premises

Animal accommodation and facilities

Veterinary surgeon details

Address of veterinary surgery

Emergency key holder 1 details

Correspondence details

Emergency key holder 2 details

Correspondence details

Public liability insurance

Disqualifications and convictions

Has the applicant or any person who will have control or mangement of the establishment ever been disqualified from any of the following:-

Additional information

Please check local guidance notes and conditions for any information which may be required in this section

Declaration

I declare that the answers given in this application to the best of my knowledge and belief, are correct and I am not ineligible for any reason from holding or obtaining a licence for which I am now applying.

I understand that failure to provide all the information required may result in my application being rejected or delayed.

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