Judges Questionnaire 4

Hon Secretary Mrs Ruth Hussey-Wilford Yen Dor Old Rydon Lane Exeter Devon EX2 7JW

This questionnaire should be completed and returned to the secretary to the Judge’s Sub-committee;
Mr Kevin Moore, 52 High Street, Fareham, Hants PO16 7BQ
by 30 November to be considered for inclusion on the list of the following year.

Name _______________________________________________________

Address _____________________________________________________

Town/City ____________________________________________________

Post Code _____________________________

Telephone ______________________

Email Address ________________________________________________

1. How long have you been interested in the Parson Russell Terrier? __________________________

a) As an Exhibitor__________ b) As a Breeder ____________________

Give a brief résumé of your interest _____________________________________________________

_________________________________________________________________________________

2. Do you hold a Kennel Club Affix? YES/NO* If YES, what is it? _____________________________

3. Please state the approx. number of PRTs that have been registered in your name at the Kennel Club _____

4. a) Please state other breeds with which you are involved________________________________________

b) Do you award CCs in these breeds? YES/NO*

c) Please state breeds in which you award CCs ________________________________________________

d) Please give details of your involvement with these breeds
______________________________________________________________________________________

______________________________________________________________________________________

* Delete as appropriate

5. Please give details of all KC Licensed shows at which you have judged PRTs since 9/1/1990

Name of Society	Date	Type of Show	No. of Classes¹	No. of Dogs Entered	No. of Dogs Judged






Totals

¹ Include only those classes in which dogs were present

6. Please give details of all KC Licensed shows at which you have judged other breeds

Name of Society	Date	Type of Show	No. of Classes²	No. of Dogs Entered	No. of Dogs Judged³






Totals

7. a) Have you attended a breed specific Teaching Seminar? YES/NO*. If YES please give place and date ______________________________________________________________________________________
b) Have you attended a breed specific Assessment Seminar? YES/NO*. If YES please give place, date and result. ________________________________________________

If “Passed” please enclose a copy of your Certificate

c) Have you passed the KC Examination on Show Rules and Ring Procedures? YES / NO /NA.* If YES please give

1. Name of Society holding the Examination____________________________

2. Date of Examination_____________________________________________

3. Please enclose a copy of your certificate

d) Have you attended a seminar given by KC Accredited Trainer on Movement and Conformation? YES / NO/ NA.*
If YES please give

1. The Name of the Society holding the Seminar _____________________________________

2. Date of the Seminar ________________________

3. Please enclose a copy of your certificate

e) Have you attended a seminar given by KC Accredited Trainer on Movement and Conformation which included a hands-on assessment? YES / NO/ NA.*
If YES please give

1. The Name of the Society holding the Seminar _____________________________________

2. Date of the Seminar ________________________

3. Please enclose a copy of your certificate *Delete as appropriate

8. If you are applying for entry to the A3 List please give details of your Stewarding experience (KC Policy)

Name of Society	Date	Type of Show	No. of Classes






Totals

9. Did you own or had you bred more than three dogs when you gained your first entry in the Stud Book? YES / NO / NA*
If YES give the Names of the dogs and their Stud Book Number _______________________________________________________________________________________

_______________________________________________________________________________________

10. Please give any further details, which you may feel are important concerning your experience in the breed and which might help the Committee in its decision, or include your C.V.

DECLARATION

I hereby certify that, to the best of my knowledge the information I have given is correct

Signed _________________________________________ Date_________________

*Delete as appropriate