Judging List Application Form
BRITISH SAMOYED CLUB
Application Form for Consideration for Inclusion on our Judges Lists.
Please complete the form and send/email it, before November, to:
Mrs V Freer, Woodview, Lichfield Road, Whittington, Nr Lichfield, Staffs WS14 9JY.
Email: val@nikara.co.uk
Page breaks have been inserted so make sure you scroll down to the bottom of each page
to ensure you have completed the whole form
Each field will automatically increase in size as you add details.
Clicking at the end of a line inside the field will automatically add a row
Your personal details:
Name:
Address:
Post Code:
E-mail:
Tel:
Fax:
Affix:
Your experience with Samoyeds:
Owned, bred or shown?
Indicate any of the following that apply. (double click on the box and replace with an ‘x’)
□ Owned □ Shown □ Bred
□
□ Not applicable (skip next question)
How long have you shown samoyeds?
□ Not applicable (skip next question)
How many Samoyeds have been bred or owned by you and listed in the KC Stud Book?
Not applicable (skip to next question)
How many dogs, of other breeds, bred or owned by you are listed in the KC Stud Book?
(give breed)
□
List those breeds for which you have been approved to award CCs and any Groups you
are passed for at Ch. Shows:
In which year did you first judge Samoyeds?
Please list any Breed Education or Judging Seminars relating to Samoyeds you have
attended:
Date:
Breed Club
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Judging List Application Form
Have you passed an approved judging assessment for Samoyeds? Please attach a copy of
certificate/s Yes □
No □
□ Not applicable
Please list any Breed Education or Judging Seminars relating to other breed/s you have
attended:
Date and Breed
Club/attendance/assessment
If you have been passed to award Challenge Certificates in any breed indicate ‘Not
applicable’ in the next four Questions.
Have you attended a Kennel Club Regulations & Judging Procedures Seminar given by a
KC accredited trainer and passed the relevant examination? Yes □
No □
□ Not applicable
Have you attended a Kennel Club Conformation & Movement Seminar given by a KC
accredited trainer and passed the Points of the Dog? Yes □
No □
□ Not applicable Please attach a copy of certificate/s
Have you passed the Points of the Dog Assessment? Yes □
□ Not applicable Please attach a copy of certificate/s
Have you completed 12 stewarding appointments? Yes □
List your Stewarding experience:
Date
Show
Date
No □
No □
Not applicable □
Show
Use the space below to give any other details relevant to your Application:
How do you support the breed, or in what way have you supported it in the past.
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Judging List Application Form
Give details of your judging experience of SAMOYEDS:
You may cut and paste a table generated from a spread sheet but please ensure the
headings are as set out below
Date
Society
Type of
Show
No. of
Classes
Judged
No. of
Dogs
Entered
No. of
Dogs
Present
Notes:
 A zero entry in a class does not count as a class judged. If 4 classes were scheduled and 1 had a zero
entry, then only 3 classes were judged.
 Only list Limited, Open and Championship Shows. Please be sure to annotate Championship Shows
without CCs as “Open” or “No CCs”.
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Judging List Application Form
Give details of your judging experience of other Breeds:
You may cut and paste a table generated from a spread sheet but please ensure the heading
are as set out below. You may continue on a separate sheet if this is more convenient
Date
Society
Type of
Show
Variety
No. of
Classes
Judged
No. of
Dogs
Entered
No. of
Dogs
Present
Notes:
 A zero entry in a class does not count as a class judged. If 4 classes were scheduled and 1 had a zero
entry, then only 3 classes were judged.
 Only list Limited, Open and Championship Shows. Please be sure to annotate Championship Shows
without CCs as “Open” or “No CCs”.
 When listing breeds such as Chihuahuas, Dachshunds and Poodles it is important to list the ‘variety’
separately
Judging List Criteria
The Judging list criteria for the breed is available on the British Samoyed Club website
www.british-samoyed-club.co.uk
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Judging List Application Form
Give details of other Breeds societies where you are listed on a Breed Judging List:
Year
Of
election
Breed
Society
List (A1,203, B or C)
Data Protection Act:
In signing this form I agree that my details may be held electronically and my name, address and telephone number will published
annually in this Club’s Judging Lists which are made available to the Kennel Club and other Registered Societies and may also be
circulated to interested general societies and made available on the Internet.
Declaration: I wish to apply for inclusion on this Club’s Judging List. I understand that the decision as to
whether my name is included on the Judging List, is the responsibility of the Club and is final.
The information I have given is accurate to the best of my knowledge and belief. I understand that
documentary evidence of statements may be required and must be provided if requested by the British
Samoyed Club/Joint Judging Committee
Signed:
Date:
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