Self-Certification Form 2025

GSLDTC Semi-Annual Self-Certification

In exchange for no-cost classes, we ask members to contribute to the club by volunteering twice every six months and confirming their efforts through a simple form.

Submit a form in January for your volunteer work in July to December of the previous year. Submit a form in July for your volunteer work in January to June.

Please complete this form and send to Jodie Hanson @ jodhan801@msn.com or mail to 1313 Morning Oaks Drive, Taylorsville, UT 84123
This form is for my volunteer work covering the months

July - December of the previous yearJanuary - June of the current yearOther
Today's Date

MonthDayYear
Date
Full Name
Email Address
example@example.com
What months did you attend general meetings?

FebruaryAprilJuneAugustOctober
What training classes did you instruct?

ObedienceRallyScent WorkTrackingTricksATT
What months did you instruct?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
What training classes did you assist?

ObedienceRallyScent WorkTrackingTricksATT
What months did you assist?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
What months did you help with class sign-ups?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
What month(s) did you volunteer a minimum of four hours at a scent work trial?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
What month(s) did you steward a minimum of four hours at an obedience or rally trial?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
What month(s) did you help set-up at a obedience, rally or scent work trial?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
What month(s) did you help clean-up at an obedience, rally or scent work trial?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
What month(s) were you a tracking trial tracklayer (including Chief Tracklayer)?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
What committee were you a committee lead (chairperson)?
What month(s) were you a committee lead (chairperson)?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
Board Member/Officer: List Position
Other - Be Specific
Where did you participate in a public demo or education?
What month(s) or date(s) did you participate in a public demo or education?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberOther
What committee were you a committee member?
What month(s) were you a committee member?

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovember
Testing Evaluator?

CGCStar PuppyATTOther
Other - Be specific and please includes dates/months.
Should be Empty:

Other - Be Specific