Akc Parent Club Recommendation -Approval For Member Of Club Form

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Judging Operations Department
PO Box 900062
Raleigh, NC 27675-9062
Phone (919) 816-3570
Fax (919) 816-4225
September 2015
–
PARENT CLUB RECOMMENDATION
APPROVAL FOR MEMBER OF CLUB
P
. Designated areas of applications should be completed before submitting to the
LEASE TYPE OR PRINT IN BLACK OR BLUE INK
Department for consideration. Request must include certified copy of meeting minutes at which action was taken by the Parent
Club Board. All attachments should be identified with the recommended name. Reminder: even if the Department views the
request favorably, the approval is not final until the recommended individual has met all requirements as outlined in the Judging
Approval Process. Please keep copies for your records. All forms available at:
shows/judging-information/
Parent Club:________________________________________________________ Date of Recognition:____________________
INDIVIDUAL RECOMMENDED FOR APPROVAL
__________ Name:_______________________________________________________________Member since:_____________
Mr./Mrs./Miss/Ms.
Address:________________________________________________________________________________________________
City:___________________________ State:______ Zip code:__________ Email:_____________________________________
Over 21 years of age?  Yes  No
Verify Email: _______________________________________
Home Phone #________________Work Phone #_________________Fax #_________________ Cell Phone# _______________
LIST BELOW ACCOMPLISHMENTS OF THE INDIVIDUAL BREEDING/OWNING/EXHIBITING IN THIS BREED:
Upon submission of this recommendation, the Department will review request of Parent Club at the next available meeting. The Parent Club will
be notified by the Judging Operations Department of their decision. The applicant approved by the Department will be notified and must fulfill all
remaining criteria including: provide letter of synopsis defining experience and background in that breed, must take and pass Procedural, Anatomy
and Breed Standard exam, pass procedural interview and applicable scales and/or wicket exam to be conducted by an AKC Executive Field
Representative and submit a non-refundable $25 processing fee. Upon completion of all requirements, the results will be reviewed by the
Department at the next available meeting for final consideration. Recommended individual will be notified by the Judging Operations Department
of the results. Those approved must complete three permit assignments and may request regular status.
F
P
C
S
C
M
E
ORM MUST BE COMPLETED BY
RESIDENT
OR
ORRESPONDING
ECRETARY
OPY OF
INUTES
NCLOSED
__________________________________________
________________________________________________________
P
N
S
D
RINT
AME
IGNATURE
ATE
Completed form may be printed and signed or signed eletronically. All forms and verification items may be submitted by mail, email or fax to
the Judging Operations Department.

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