ASFA Judges License Application

Is this an application to Apprentice Judge or application for Provisional License?
Name
Last, First, Middle
Address
City
State
Zip
Phone Number

Area CodePhone Number
Sex
E-mail
Please list up to five sighthounds that you own or co-own:

Rows	Breed	Registered Name	Registration#	Titles
1
2
3
4
5

Please indicate, by number, which of the hounds listed above is working on its FieldChampionship/LCM:
Have you read, and do you have a working knowledge of, the current ASFA Running Rules and Field Procedures for Lure Field Trials?
If Yes, What Year?
If No, Please Explain
Are you in good standing with ASFA?
If No, Please Explain
Have you met all the requirements for a provisional license?
If No, Please Explain
How many Lure Trials do you attend each year?
How many of these are given by your club?
How many of these are given by other clubs?

In what capacities have you worked at Lure Field Trials, other than as a judge? (e.g., Huntmaster, Lure Operator, Field Clerk, FieldTrial Secretary, etc.)

Rows	Trial Date	Host Club	Positions
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2
3
4
5
6
7
8

If applying for Provisional License, please complete a chart for each trial at which you apprentice judged, indicating the judge you apprenticed under, the breeds judged, and the number of entries for each breed. If applying to Apprentice, please skip the chart but sign at the bottom of the page.

Rows	Name of Licensed Judge	A	AZ	Ba	B	CE	G	Ib	IW	IG	P	RR	S	SD	SL	W
1
2
3
4

Trial Date

MonthDayYear
Date
Host Club

Rows	Name of Licensed Judge	A	AZ	Ba	B	CE	G	Ib	IW	IG	P	RR	S	SD	SL	W
1
2
3
4

Trial Date

MonthDayYear
Date
Host Club

Rows	Name of Licensed Judge	A	AZ	Ba	B	CE	G	Ib	IW	IG	P	RR	S	SD	SL	W
1
2
3
4

Trial Date

MonthDayYear
Date
Host Club

Rows	Name of Licensed Judge	A	AZ	Ba	B	CE	G	Ib	IW	IG	P	RR	S	SD	SL	W
1
2
3
4

Trial Date

MonthDayYear
Date
Host Club
Upload additional pages as necessary to indicate all apprentice judging.

Browse Files

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Ifapplying for Provisional, attach judging confirmation statements and all judgessheets for the above apprenticing.

Browse Files

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I understand that my name, address, telephone number, and e-mail address will be published on the ASFA website. I certify that, in the event that physical disability, whether permanent or temporary, which would limit my ability to judge, walk the field as required by Chapter 3, Section 4 of the Running Rules, or limit the type of terrain I can walk through, I will advise the trial-giving club the extent of this disability at the time an assignment is accepted, or as soon as possible in the event of a new disability.

I certify that I am 18 years of age or older and that the information given herein is true and correct to the best of my knowledge.
Signature
Date

MonthDayYear
Date
Should be Empty:

Please list up to five sighthounds that you own or co-own: