Regular Rally Judging Application

I am applying for REGULAR STATUS approval to judge all AKC Rally classes.

Judge No.*

Name

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number*

Please enter a valid phone number.

Email *

(If approved, the contact information provided will be listed in the judges' directory unless otherwise noted.)

To request regular status, judges must judge a minimum of ten (10) assignments with a minimum cumulative total of three hundred and fifty (350) dogs competing. In addition, two (2) satisfactory judging observations must be obtained, with one of the observations being completed within one year prior to the request for regular status.

Total Number of Assignments:*

Total Number of Dogs Judged:*

Observations

	Field Representative	Date	Class	Number of Dogs
1.
2.
3.
4.

List AKC Judge's Education webinars and/or seminar :*

	Specific Type	Date
1.
2.
3.
4
AKC Stewards of Children

Please note that all judges are required to complete all available AKC Rally Judges' webinars and/or seminar every three-years. If this requirement is not net, you may be ineligible to accept assignments.

I certify that I understand and acknowledge that if I am charged with cruelty, inhumane treatment of animals, or similar offenses involving inhumane or cruel treatment of dogs, or charged with any crime involving moral turpitude, especially as it concerns dog-related activities, the AKC may temporarily place my judging privileges on referral while the charges are pending. Further, after receiving notification of the referral, I am prevented form judging or from accepting assignments to judge. When the charges are resolved and AKC's inquiry into the matter determines that no action will be taken by the AKC to cause a suspension of my judging privileges, the temporary judging referral will be removed.

"I certify that I am a member in good standing with the American Kennel Club, 21 years of age or older, and that all information submitted in this application is truthful and accurate."

I (we) certify that electronic typed signatures sent via email shall serve as original signatures.

Signature:*

Date*

Date

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