CAVALIER KING CHARLES SPANIEL CLUB, U.S.A., INC. APPLICATION FOR PERFORMANCE JUDGE PROGRAM

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APPLICATION FOR PERFORMANCE JUDGE PROGRAM Application to start the process of becoming an Approved Obedience or Rally Obedience Judge for the CKCSC-USA. Please print or type. Attach additional sheets, if needed. Submit to Chair, the Judges Committee NAME Last First Initial Home Address Business address Street Street City State Zip City State Zip Home telephone (AC)xxx-xxxx Applying for: E-mail address ( ) Rally Judge Program ( ) Obedience Judge Program REQUIREMENTS A resident of the USA: Yes No A current member in good standing of the CKCSC-USA, Inc. for a minimum of the last consecutive five (5) years with no charges pending with the CKCSC-USA Ethics Committee. Yes No If No, 1. A letter of recommendation from another kennel club or training club must be attached. 2. The name of the Kennel Club of your recommendation. 3. Are you a current member in good standing with the above kennel club for a minimum of the last consecutive five (5) years. Yes No Have exhibited at a minimum of two (2) Obedience Trials per year for the last five (5) consecutive years. Yes No Have exhibited at a minimum of two (2) Rally Trials per year for the last five (5) consecutive years. Yes No Have attended an Obedience/Rally seminar within the past year. Obedience Yes No Rally Yes No If you have not, you will be required to attend before completion of requirements. Over eighteen (18) years of age. Yes No EXPERIENCE Achievment Kennel Club (ie: AKC,UKC) Obedience/Rally Titles Year Dog s Registered Name CKCSC-USA Application for Performance Judge Program page 1 of 3.

APPLICATION FOR PERFORMANCE JUDGE PROGRAM Other Training Experience: Training Club Classes Instructed # years Seminars/workshops: Date Location Sponsor Topic Dog club memberships Yr(s) of membership Offices held and yr(s) Obedience/Rally Stewarding Assignments (attach steward/chairperson assignment form signed by show secretary, club officer or class judge for all shows listed below) Date Show Name Location Class #Entries Obedience/Rally Chairperson Assignments (attach steward/chairperson assignment form signed by show secretary, club officer or class judge for all shows listed below) Date Show Name Location Class #Entries Have you been disciplined by, suspended or expelled from CKCSC-USA [ ] no [ ] yes Give particulars: Other dog club [ ] no [ ] yes Give particulars: CKCSC-USA Application for Performance Judge Program page 2 of 3.

APPLICATION FOR PERFORMANCE JUDGE PROGRAM I am enclosing, list number of forms each; [ ] Performance Steward/Chairperson Assignment Completion Form(s). [ ] Recommendation(s) from another Kennel Club. [ ] Attendance verification(s) of AKC or APDT Obedience and /or Rally seminar. [ ] Seminar or workshop Attendance verification(s). [ ] Other,specify I understand that judging CKCSC-USA, Inc. and its member clubs' events is a privilege that can be withdrawn for cause. By signing and submitting this Primary Application I agree to be bound by the rules promulgated by the Board of Directors, CKCSC-USA and that the information supplied herein is true and correct to my knowledge. Also the information supplied is correct and true to my knowledge Signature Date CKCSC-USA Application for Performance Judge Program page 3 of 3.

PERFORMANCE SEMINAR ATTENDANCE FORM Form to be used to confirm Obedience and/or Rally Seminar attendance and completion. Form should be submitted with the CKCSC-USA Performance Judge Application. Applicant s Name: Date Seminar: ( ) Obedience ( ) Rally Club sponsoring seminar: Club s affiliation: ( ) AKC ( ) CKC ( ) APDT ( ) ASCA ( ) Other Date of Seminar: Location: The information below is to be completed by the seminar instructor or sponsoring club representative. I certify that the applicant attended and completed the seminar courses indicated above. Instructor or Club representative Name (print) Title Signature Date

PERFORMANCE STEWARD/CHAIRPERSON ASSIGNMENT COMPLETION FORM Form to be used to confirm Obedience and/or Rally Obedience stewarding and/or chairperson assignments completed. Evaluator of assignment should be the show secretary, club officer or class judge of the show. Form should be submitted with the CKCSC-USA Performance Judge Application. Please print or type. If you need assistance in obtaining an assignment, please contact the Judges Committee Chairman. Applicant s Name: Date Position: ( ) Obedience Steward ( ) Rally Steward ( ) Obedience Chairperson ( ) Rally Chairperson Class(es) # of Entries ( ) Novice Obedience ( ) Open Obedience ( ) Utility Obedience ( ) Novice Rally ( ) Advanced Rally ( ) Excellent Rally Show: Location: Date: Kennel Club s affiliation: ( ) CKCSC-USA ( ) AKC ( ) CKC ( ) Other The information below is to be completed by the show secretary, kennel club officer or class judge. I certify that the applicant served as indicated above. My evaluation of applicant s proficiency: [ ] Excellent. Capable of performing this task independently. [ ] Satisfactory. Can perform this task with minimal assistance. [ ] Fair. Will need additional experience/tutoring (Please explain under comments) [ ] Unacceptable. Not suitable for this task (Please explain under comments) Would you recommend this applicant to perform the above specified function for your kennel club or another kennel club? [ ] yes [ ]no Comments Print name of evaluator Signature of evaluator Title Date

PROVISIONAL PERFORMANCE ASSIGNMENTS COMPLETION FORM Form to be used to confirm Obedience and/or Rally Obedience judging assignments completed. Assignment MUST be critiqued by an approved CKCSC-USA Obedience and/or Rally judge or a AKC Obedience and/or Rally judge who is also approved for the classes being critiqued. Please print or type. Submit to Chair, the Judges Committee. Provisional Judge: Date Class(es) # of Entries ( ) Novice Obedience ( ) Open Obedience ( ) Utility Obedience ( ) Novice Rally ( ) Advanced Rally ( ) Excellent Rally Show: Location: Date: Kennel Club s affiliation: ( ) CKCSC-USA ( ) AKC ( ) CKC ( ) Other The information below is to be completed by the critiquing judge. Provisional Judge's appearance Provisional Judge's attitude towards dogs and exhibitors I certify that the Provisional Judge served as indicated above. My evaluation of the his/her proficiency: [ ] Excellent. Capable of performing this task independently. [ ] Satisfactory. Can perform this task with minimal assistance. [ ] Fair. Will need additional experience/tutoring (Please explain under comments) [ ] Unacceptable. Not suitable for this task (Please explain under comments) Would you recommend this Provisional Judge to perform this function at your kennel club s performance shows? [ ] yes [ ]no Comments Print name of evaluator Signature of evaluator Title Date

Date: PERFORMANCE JUDGE CONTRACT Club: Club Representative: Name: Address: Contact info: Judge: Name: Address: Contact info: This is to confirm that (judge s name) has agreed to judge; Obedience trial classes (indicated below) Novice A & B Open A & B Utility A & B Non-regular classes (Pre-Novice, Brace, Grad-Novice, Veteran) Rally trial classes (Novice A & B, Advance A & B, Excellent A & B) on (date of event) at (location of event) All classes will be performed and judged according to the AKC class rules and regulations. This is not an AKC-licensed trial. The CKCSC-USA is a club entirely independent of the AKC, and it awards its own obedience titles and rally titles using AKC obedience and rally rules. The above named club has agreed to the following terms; Judge s fee payable to judge at conclusion of judging; Other charges to be reimbursed to the judge; CKCSC-USA Performance Judge Contract page 1 of 2.

PERFORMANCE JUDGE CONTRACT We, the above named judge and representative have agreed to the terms listed above; signature of club representive signature of judge date date Please sign one copy of this contract to acknowledge receipt, and return it in the stamped, addressed envelope enclosed. The other copy is for your use. The club representative will contact you one week before the show, via phone, with the number of entries the club has received per class. In our catalog, we like to provide information on our judges for exhibitors who may not know them. When you return the copy of this letter, please also send a brief resume of your background in dog training, judging experience, breeds owned, classes taught, or club membership. Thank you so much for agreeing to judge specialty show. If you have any questions about this judging assignment, please do not hesitate to contact the club representative. CKCSC-USA Performance Judge Contract page 2 of 2.

APPLICATION FOR REINSTATEMENT PERFORMANCE JUDGE STATUS Application to reinstate Performance Judge s Status for a CKCSC-USA member. Please print or type. Attach additional sheets, if needed. Submit to Chair, the Judges Committee Date Name of Candidate Signature Address Telephone # Street City State Zip CKCSC-USA MEMBERSHIP Yrs of membership 19 to Official club positions held since obtaining or last renewing Judge's Permit: Have you been disciplined by, suspended or expelled from CKCSC-USA or other dog club [ ]no yes[ ] Submit particulars I have served in the following capacities at the past 18 trials prior to this application. Obedience/Rally Chairperson Assignments (attach steward/chairperson assignment form signed by show secretary, club officer or class judge for all shows listed below) Date Show Name Location Class #Entries Have you been disciplined by, suspended or expelled from CKCSC-USA [ ] no [ ] yes Give particulars: Other dog club [ ] no [ ] yes Give particulars: I am enclosing, list number of forms each; [ ] Performance Steward/Chairperson Assignment Completion Form(s). [ ] Recommendation(s) from another Kennel Club. [ ] Attendance verification(s) of AKC or APDT Obedience and /or Rally seminar. [ ] Seminar or workshop Attendance verification(s). [ ] Other,specify I understand that judging CKCSC-USA, Inc. and its member clubs' events is a privilege that can be withdrawn for cause. By signing and submitting this Reinstatement Application I agree to be bound by the rules promulgated by the Board of Directors, CKCSC-USA and that the information supplied herein is true and correct to my knowledge. Also the information supplied is correct and true to my knowledge Signature Date

JUDGES COMMITTEE CHECK LIST OF PERFORMANCE JUDGE APPLICANT Applicant Date Applying for (mark only one program per form): ( ) Rally Judge Program ( ) Obedience Judge Program STEWARD ASSIGNMENTS Show Date Evaluation by S/N* Comment PROVISIONAL JUDGING ASSIGNMENTS (CRITIQUES) Show #dogs ADDITIONAL ITEMS SUBMITTED FOR CREDIT: Comments *S=satisfactory, N= not satisfactory FOR JUDGES COMMITTEE Application is [ ] incomplete Applicant notified Date by Name Application is [ ] complete Date Applicant was contacted on to arrange a meeting for written examination. Written Examination: Date Location Committee Rep. Pass/Fail Applicant granted Provisional Judging status on. CKCSC-USA Judges Committee Check List for Performance Judge Application 1 of 2.

JUDGES COMMITTEE CHECK LIST OF PERFORMANCE JUDGE APPLICANT Applicant Date Applying for (mark only one program per form): ( ) Rally Judges Program ( ) Obedience Judges Program All Required Provisional judging assignment and critiques have been received on. Applicant was contacted on to schedule final interview for approval. Final Interview date: Final Interview attendees: Name (print) Signature Applicant is [ ] acceptable [ ] not acceptable to the Committee Comments CKCSC-USA Judges Committee Check List for Performance Judge Application 2 of 2.