PerformanceEventOperations
P.O.Box 900051
Raleigh,NC27675-9051
Tel: 919 816-3908Fax: 919 816-4211
POINTINGBREED or SPANIELFIELD TRIAL APPLICATIONand
JUDGES PANELforAKC LICENSED/MEMBER CLUBS
Event # / Club NameDate Start / Event Type
Date End / Site Name
Address
Please read instructions and application carefullybeforecompleting
Please typeorprintall information.
ConsentfromyourParentClubmustbeobtainedinwritingandmustbeintheofficeofThe
American Kennel Clubbefore thisapplication canbeconsidered.
Forfinalapproval,thefollowingmustbecompletedandreturnedtoAKCPerformanceEvents
atleastthree (3)months*priorto thestartofthe trial: CompletedApplication
Judges Panel
ApplicationFee
Currentmembership and officerlist
CurrentBy-Lawsmustbeattachedif thisistheclub’sfirstlicensedtrial,ofif
revisionshave been made sincethelastsetwas filedwiththeAKC.
Submitallofthe above information together
Alicensefeeof$35.00istobesubmittedwitheachapplication.Nofeeisrequiredofa Member Clubforthefirsteventwithinacalendaryear.A$15.00feemustaccompanyan application foranadditional memberclubeventto beheld within thatyear.
*Amonetaryfine($50.00)willbeimposedforanapplicationand/orjudgespanelnot receivedatleastthree(3)monthspriortothescheduledstartofthetrial. Aneventwillnot beapproveduntil thefineis received.
WhenapprovedbyTheAmericanKennelClub,theinformationgivenonthisformmustbe printedin thePremiumListalongwithanyotherinformationrequiredundertherespective FieldTrialRules. AsstatedinAKC’sRulesandRegulations,PremiumListsmaybeprinted onlywhentheclubhasreceivednoticesthatboththeeventapplicationandthejudgespanel
havebeenapproved.ClubsmustsubmitpremiumliststoTheAmericanKennelClubatthe timeofdistribution.Failuretodosomayresultinafine,failuretoreceiveapprovalforfuture events,orboth.
ONCEANEVENTHASBEENAPPROVED,NOREFUNDSWILLBEISSUEDFOR THE APPLICATION FEES OR FINES.
This event is held under the Rules and Procedures of The American KennelClub. The informationonthisform,whenapprovedbyTheAmericanKennelClub,shallbefinalandno changes may be made withoutauthorizationfromThe AmericanKennel Club.
AF2PSL(12/11)
PLEASE INDICATE THE APPROPRIATE TRIALTYPE:SPANIELS
Oneormorestakes will beofferedfor:English SpringerSpanielsCockerSpaniels*
Water Test:YesNOEnglish CockerSpaniels*
*Note:StandAloneWaterTestshostedbyCockerSpanielandEnglishCockerSpanielclubs may beopen toonly those breeds
POINTINGBREEDS
Specify Limit,ifany: Numerical Daylight FlexibleFormat
Water Test:will beheld will notbeheld
FIELD TRIAL SECRETARY
Name CompleteStreet
Address
------
Telephone
HomeBusiness/Cell
FirstDateentries will beaccepted:
Exact LocationHourDayofWeekDate
Entries will close with theField Trial Secretary:
Exact LocationHourDayofWeekDate
Drawingwill take place:
Exact LocationHourDayofWeekDate
FIELD TRIAL COMMITTEE Field TrialChairman:
Name
StreetAddressTelephone
HomeBusiness/Cell
Field TrialCommittee Members(listatleast5):
NeithertheField Trial SecretarynoranymemberoftheField Trial Committeewill beapproved as aJudge to beadvertisedorpublished in thePremiumList.
ENTRIES ARE TOBE RECEIVED BY THE FIELD TRIAL SECRETARY
AF2PSL(12/11)2
STAKE / RETRIEVING STAKE(YesorNo) / RUNNING ORDER
(datetime) / OPEN TOTHE FOLLOWINGBREEDS / ENTRY FEE
AKCFIELD TRIAL JUDGES PANEL QUESTIONNAIRE
Approvalofjudgesissubjecttothequalificationrequirementsatthetimeoftheevent.Before anyadvertisedJudgeshallbeeligibletojudgealicensedormember fieldtrial,hemustbe licensed bytheAKC PerformanceEventsDepartment.
JudgeNumber / Nameand CompleteAddress / Telephone
Number / Stakes to be Judged
AF2PSL(12/11)3
OFFICERS OF THE CLUB
President
NamePhoneNumbers
CompleteStreetAddress
EmailAddress
Vice
President
NamePhoneNumbers
CompleteStreetAddress
EmailAddress
Secretary
NamePhoneNumbers
CompleteStreetAddress
EmailAddress
Treasurer
NamePhoneNumbers
CompleteStreetAddress
EmailAddress
TheclubcertifiesthatacompletedDisasterEmergencyPlanwillbeavailableat the event.Bycheckingthisbox,acompletedplannolongerneedstobesubmittedwith application.
Application submittedby:
SignatureofClub OfficerDate
PrintedNameandTitleofClub Officer
AF2PSL(12/11)4