FCI – IPO, Mondioring
or FH Championship Team
Declaration Form for the AWDF: FH__ IPO__ MR__
(Check
one)
Section 1 - Candidate Information
Name of Handler: __________________________________________________________________
Address: ________________________________________________________________________
Contacts: Hm Phone_________________Wk Phone_________________Mobile________________
Fax ______________________ Email__________________________________________
Name of Owner: ___________________________________________________________________
Address: ________________________________________________________________________
Phone: _______________________Email________________________________________
Uniform Size (women: indicate both gender and unisex
sizes):
Jacket_____________________ Pants____________________
Section 2 - Dog Information
Dog’s Registered Name: _________________________________________Breed_______________
Gender: ____ DOB______________ Tattoo____________________Tattoo
Location_____________
Dog’s Registration Number and Club of Registry:
_________________________________________
Sire’s Name__________________________________________Registration
No.________________
Dam’s Name_________________________________________ Registration
No.________________
Section 3 - Other
Is this a handler-owner-trained dog? YES ____ NO____
(Owner must have owned the dog from 6 months of age)
Scorebook No._____________ Club issuing Scorebook: ________________________
Top two national level scores within the past 12 months:
_______________ and_________________
Mondioring candidates see criteria on website (www.usmondioring.org).
NOTE: PLEASE ATTACH A COPY OF THE RELEVANT PAGES OF
YOUR SCOREBOOK FOR SCORE VERIFICATION AND A COPY OF COMPLETE PEDIGREE.
The submittal of this form is a formal declaration candidacy
for the AWDF FCI World IPO, Mondioring or FH Championship Team. I am a
member of my AWDF club and in good standing. I realize that withdrawal
from the team once the selection process has been finished could result
in unfavorable reviews in subsequent years. I understand I will be responsible
for all expenses not covered by the club or AWDF (check with your club
and the AWDF for details).
___________________________________
Candidate Signature |
_________________
Date |
CANDIDATES: Send this form to your relevant AWDF
club; it will be submitted to: Chairperson, AWDF Team Selection Committee
by June 10(IPO), August 1 (Mondioring) or December 10 (FH).
The top two eligible dog-handler teams from the AWDF IPO and FH2 Championships
may send the Declaration Form directly to the chairperson. Mondioring
dog handler teams will send directly to the MR chairperson.
AWDF MEMBER (AND GUEST MEMBER) CLUBS: Submit
your declared candidates by June 10 (IPO), August 1 (Mondioring) or December
10 (FH) Be sure to send the copies of the scorebook verifying the scores
indicated above and the pedigree. This will greatly expedite entering information
on the entries. Each breed club may send up to 6 nominees for the
IPO team and 4 for the FH team. The Mondioring team can consist of
6 nominees.
Augusta Farley, Chair
AWDF/FCI Team Selection Committee 2631 Olive Avenue
Patterson, CA 95363
Phone: 209.892.3114
E-Mail: augusta@ducielrouge.com |
Ann Putegnat, Chair
Mondioring Team Selection
400 Hidden Oak
Bulverde, TX 78163
Phone: 830.438.3327
Email: annwp3@yahoo.com |
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