judge_application

                                                                            AMERICAN DOG FEDERATION
                                                                              Application for Judges License

PLEASE TYPE OR PRINT IN BLACK OR BLUE INK. All designated areas of the application should be completed before attaching additional
documentation. All attachments should be identified with your initials or name. Please keep copies for your records. Reminder: Enclose your
processing fee of $25.00 per breed and an additional fee of $25.00 for Junior Showmanship. $25.00 For each level in the Obedience/Tracking/Agility
venue. All fees are non-refunadable.

Name:
First [___]___]___]___]___]___]___]___]___]___]___]    Last [___]___]___]___]___]___]___]___]___]___]___]___]

Address                                                                                                             City

[___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]
State/Country                                                                                                                                                                               Zip/Country Code

]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]

Email:[___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]

Home Phone: Country Code Cell Phone:

[___]___]___]___]___]___]___]___]___]___] ___________ [___]___]___]___]___]___]___]___]___]___]

Please provide the following information printed on a separate sheet/s of paper attached to this form.

Breed(s) for which you are submitting an application.
Obedience levels if applying for an obedience license.
A resume of your experience in dogs ie.breeding, training etc.
Please also include any history of livestock judging.
List any other judging experience.
Number of years with dogs.
Breeds in which you have experience

Method Of Payment
(   ) Credit/Debit Card   (   )Paypal*      (   )Check     (   ) Money Order
Please include *Paypal invoicing email address below if different than above.

[___]___]___]___]___]___]___]____]____]___]___]___]___]___]___]___]___]___]___]___]___]___]

Print name as it appears on credit/debit card:

_______________________________________________________________________________________
Credit card #                                                                                                                                                  Exp. Date           CVC Code

[___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]___]     [___]____]   [___]___]___]

Signature of Applicant:______________________________________________Date____/________

Please make checks or Money Orders Payable to: American Dog Federation
Mail to: American Dog Federation
PO Box 63
Rosebush, Michigan   48878
989-433-8015