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Lost Dog eForm
Please note * denotes a mandatory field
Reference Code: QVG232550937
Personal Details
Title:    
* Forename:
* Surname:
* Address Line 1:
Address Line 2:
* Town / City:
* Post Code:  
* Home Telephone Number:
Work Telephone Number:
Mobile Telephone Number:
Email Address:
Dog Details
* Name:  
* Breed:      
* Age:  
Sex:  
* Size:  
* Colour Markings:  
Is the dog chipped:  
Does the dog wear a tag or disc:  
  Is the dog neutered or spayed:
You may qualify for either free neutering or reduced price neutering, for further information please call (01709) 823118		  
Further / Additional Information
To help us identify your dog better you can upload a picture.  To use this facility please have a .JPG or .GIF file ready to upload and send.  Please make sure the file is no larger then 1Mb in size (it will fit easily onto a floppy disk drive) as it will not upload.
Once submitted successfully you will be re-directed to the following page: http://www.rotherham.gov.uk/graphics/Environment/Stray+Dogs