application and judges panel for akc licensed or member...

www.akc.org of 3 AEAGIL (08/18) v1.0 EDIT

Application and Judges Panel forAKC® Licensed or Member Agility Trial

or AKC Sanctioned A or B Match

SECTION 2. TYPE OF EVENT (choose one)

AKC Sanctioned “A” or “B” Match:

AKC Licensed or Member Club Event:

(Circle One) $15.00 Application Fee. (Please indicate if A or B Match. Sanctioned A Match held to qualify for approval to hold licensed events.) Dogs qualifying at sanctioned events receive no credit toward titles. Recording fees are not required.

$100.00 for each event (held by a club that is a Member of the AKC or a club Licensed by the AKC to hold agility trials). If this is a corresponding event from the previous year, that had 30 entries or less, the application fee is $25. Dogs qualifying at licensed and member club events receive credits toward titles. Use separate applications for each event. No refund of fees for cancelled events once application is processed.

Please Continue on Back and Complete All 3 Pages of Application

SECTION 3. FEE PAYMENT

Payment Method

CheckCheck Number Amount of Check

Credit CardCredit Card Number

Expiration Date Card Type

Name on Credit Card

Billing Address

Questions? Contact us. . .American Kennel Club Companion Operations

Agility PO Box 900051

Raleigh, NC 27675-9051Tel 919 816-3725Fax 919 816-4210

www.akc.org

Total Payment Due$

If a club website is used, give address:

This application must be received by the American Kennel Club with the appropriate fees at least 18 weeks prior to the closing date of the Trial for the club to be in compliance with Chapter 1, Section 5 of the Regulations for Agility Trials. Applications for a Sanctioned Match must be filed with the American Kennel Club at least six weeks prior to the closing date of the Match. Please complete all three pages of the application.

A separate application is required for each Trial or Match date. Money penalties may be imposed or application may be rejected for noncompliance. Incomplete applications will not be approved. This event application and judges panel may be submitted using the AKC Online System at www.akc.org or send completed application with appropriate fee to:

American Kennel Club, Event Operations, PO Box 900051, Raleigh, NC 27675-9051

SECTION 1. CLUB INFORMATION

EVENT NUMBER (if known) NAME OF CLUB EVENT DATE

NAME OF THE EVENT FACILITY

EXACT ADDRESS OF THE EVENT FACILITY (Include Street Address, City, State and Zip Code)

Is this location in your Club’s Territory? Yes No (If no, attach a consent letter from the club owning the territory.)Special Attraction: Yes No (If yes, include detailed explanation and a completed form.) Subject to AKC approval.

Check here if this is a date change!


Event Role Name and Complete Mailing Address Email Daytime Phone # Evening Phone #

Event Secretary

Event Chairman

(Must be a Club Member)

SECTION 4. INDICATE THE METHOD OF ENTRY (choose one) An * identifies a required field in this section.

Is the club offering online entries through the AKC’s Online Entry Service? Yes No

If so, designate the number of total entry limit to be fulfilled by paper entries # & online entries # If using the AKC Online Entry Services, the club has read and accepts the terms and conditions [www.akc.org/events] pertaining to this service.

Mark time zone where entries will be received: Atlantic Eastern Central Mountain Pacific

A) LIMITED TRIAL TOTAL NUMBER OF RUNS AT THIS EVENT*

First Received:

Random Draw:

Opening Date *

Closing Date *

Opening Period, Start Date *

Opening Period, Finish Date *

Random Draw Date *

Closing Date *

and Time *

and Time *

AM PM

AM PM

and Time *

and Time *

and Time *

and Time *

AM PM

AM PM

AM PM

AM PM

B) UNLIMITED TRIALOpening Date*and Time* Closing Date*and Time*

Random Draw Location* (Must provide complete address, city,

state, zip code)

NAME OF CLUB EVENT DATE

SECTION 5. ADDITIONAL EVENT INFORMATION (Complete all questions to avoid a delay in event approval.)

Open to all breeds? YES NO

Open to Single Breed or Group? YES NO If YES, please indicate the Breed or Group

Check here if All American Dogs (Mixed Breeds) are not allowed to enter this event. NOT ALLOWED

Event will be held: INDOORS OUTDOORS (under cover? YES NO) BOTH

Dimensions for course area(s) # of Rings

SECTION 6. ENTRY FEES PER DOG (List all that are applicable.)

3rd Entry Fee $ 4th Entry Fee $ 5th Entry Fee $ 6th Entry Fee $ 7th Entry Fee $

1st Entry Fee $ 2nd Entry Fee $

CLUB EVENT CONTACTS

Section 7. Club officer authorization to apply to hold this event.

Club Officer Signature Club Officer Title Date


NAME OF CLUB EVENT DATE

Section 8. JUDGE PANEL List All Classes Offered, Judge’s Name, Judge’s Number, City, State. For any further division of classes (splitting Regular and Preferred, splitting A and B, dividing clases into jump heights, etc.), please contact your AKC Event Operations representative directly or email [email protected].

STANDARD (Regular & Preferred) JUMPERS WITH WEAVES (Regular & Preferred)

CLASS Judge’s Name & Judge’s Number City, State CLASS Judge’s Name & Judge’s Number

City, State

NOVICE A & B (Regular) Novice (Preferred)


OPEN (Regular & Preferred)


EXCELLENT & MASTER (Regular & Preferred)

EXCELLENT & MASTER (Regular & Preferred)

PREMIER (Regular & Preferred)

PREMIER (Regular & Preferred)

FIFTEEN AND SEND TIME (FAST) CLASS (Titling Class)

TIME 2 BEAT CLASS (T2B) (Titling Class)

CLASS Judge’s Name & Judge’s Number City, State CLASS Judge’s Name & Judge’s Number

City, State


Time 2 Beat (Regular & Preferred)


INTERNATIONAL SWEEPSTAKES CLASS (ISC) (Non-Regular Class)

EXCELLENT & MASTER (Regular & Preferred) ISC STANDARD

ISC JUMPERS WITH WEAVES

CLUBS MAY OFFER THE FOLLOWING OPTIONAL CLASSESNOTE: If not offering the FAST, Time 2 Beat, and/or ISC classes, please mark the application as “Not Offered” so AKC knows it is not being offered.

Section 9. Judge Panel Submission

Submitted for AKC approval by (Please Print) Club Position* Date*If not Event Chairman, please indicate Event Chairman’s name, address, telephone number, and email address below.

Event/Trial Chairman’s Name Address Telephone/Email Address

application and judges panel for akc licensed or member...

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