Coursing Ability Test Application Form & Judges Panel Page 2

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CLUB OFFICERS:
_________________________________________________________________
President
Name
Phone Number
_________________________________________________________________
Complete Street Address
Email Address
______________________________________________________________________________________________
_________________________________________________________________
VP
Name
Phone Number
_________________________________________________________________
Complete Street Address
Email Address
______________________________________________________________________________________________
_________________________________________________________________
Secretary
Name
Phone Number
_________________________________________________________________
Complete Street Address
Email Address
______________________________________________________________________________________________
_________________________________________________________________
Treasurer
Name
Phone Number
_________________________________________________________________
Complete Street Address
Email Address
______________________________________________________________________________________________
_________________________________________________________________
Event
Secretary
Name
Phone Number
_________________________________________________________________
Complete Street Address
Email Address
_________________________________________________________________
Event
Chairman
Name
Phone Number
_________________________________________________________________
Complete Street Address
Email Address
Test Committee Members: (minimum of 5)
_________________________________Name ____________________________________________
Name _______________________________Name_________________________________________
Name _______________________________Name_________________________________________
Name _______________________________Name_________________________________________
Coursing Ability Test Judge: [No judge in Fast CAT]
Judge #
Name
Complete Address
Phone
if applicable
____________________________________________________
Signature of Club Officer
Date
____________________________________________________
Printed Name and Title of Club Officer
2
AL2001 (02/16)

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