judges_application

DESIGNER BREED REGISTRY 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

Signature of Applicant:_________________________________________Date____/_____/_____

MAIL TO:DESIGNER BREED REGISTRY
             PO BOX 7681
            NORTH PORT, FLORIDA 34286