Essential Data Form

Please fill form out completely and accurately.

Name of Club

Date of Trial:

Country

Place of Trial

One Course

Multiple Course

Trial Run in Accordance with Minimum Requirements? Yes

Title of Stake

Amateur Invitational Points Stake? Yes

If Yes: All-Age

Shooting Dog

Judge 1

First Name

Last Name

City State Phone Email

Judge 2

First Name

Last Name

City State Phone Email

Judge 3

First Name

Last Name

City State Phone Email

For Puppies and Derbies Whelped On or After

Number of Starters:

Brittanys GSPs Pointers Setters Vizslas Other Total Starters

1st Place

Breed

FDSB# Date Whelped: Color

Sire

Dam

Owner Member # City State/Prov.

Handler Member # City State/Prov.

AFTCA Win Certificate? Yes

Eligible for Handler Points? Yes

Add New Dog

2nd Place

Breed

FDSB# Date Whelped: Color

Sire

Dam

Owner Member # City State/Prov.

Handler Member # City State/Prov.

AFTCA Win Certificate? Yes

Eligible for Handler Points? Yes

Add New Dog

3rd Place

Breed

FDSB# Date Whelped: Color

Sire

Dam

Owner Member # City State/Prov.

Handler Member # City State/Prov.

AFTCA Win Certificate? Yes

Eligible for Handler Points? Yes

Add New Dog

Club Official Completing Form

First Name

Last Name

Address

City

State/Prov.

Zip/Postal Code

Phone

Submit electronically to the AFTCA

Submit

PDF Form to be emailed or printed and sent to
The United Kennel Club

United Kennel Club – ATTN: Hunting Ops
100 E Kilgore Rd., Klamazoo, MI 49002-5584

Create PDF

Club Official Completing Form

Submit electronically to the AFTCA

PDF Form to be emailed or printed and sent toThe United Kennel Club

PDF Form to be emailed or printed and sent to
The United Kennel Club