241051-list

please fill data and click send form

Dear Judge,

We kindly ask you to fill in the questionnaire below as complete as possible.

After pressing the SendForm/Submit button a copy of the data will be sent to your email address and our administration.

Gender

male

female

Initials / first letter(s) of your first name(s)

First name (nickname)

Insertion

Surname (family name)

Date of birth (dd/mm/yyyy)

Address and house number

Zip code

Residence/Town

Country

Telephone number (home)

Mobile / GSM

E-mail

Can you accept our invitation for the Benelux Winner Show and/or the World Dog Show 2018

yes

Upload photo (min. 300 dpi)

Do you agree that we publish your photo on our website.

yes

Upload your CV. If not ready to upload you will find a text area to write your CV at the end of this form.

Do you agree that we publish your CV on our website

yes

In the ring I will use the following (FCI) language

English

German

French

Spanish

Dutch

The breeds that are dearest to me and those I would like to judge are (breed, gender and FCI number)

We will ask you not to judge the same breeds in Europe as from 1-9-2017. We kindly ask you to fill in the breeds for which you have already a judging appointment between 1-9-2017 and 1-9-2018 in Europe (please mention breed, gender and FCI number)

At the Eurpean Dog Show in Norway 2015 I have judged the following breeds (breed, gender and FCI number)

At the World Dog Show in Italy 2015 I have judged the following breeds (breed, gender and FCI number)

At the Eurpean Dog Show in Belgium 2016 I will judge the following breeds (breed, gender and FCI number)

At the World Dog Show in Russia 2016 I will judge the following breeds (breed, gender and FCI number)

At the Eurpean Dog Show in the Ukraine 2017 I will judge the following breeds (breed, gender and FCI number)

At the World Dog Show in Ecuador 2017 I will judge the following breeds (breed, gender and FCI number)

At the Eurpean Dog Show in Poland 2018 I will judge the following breeds (breed, gender and FCI number)

Breed(s) that I am a specialist for (breed and FCI number)

Any special wishes or requirements

Short CV (only to be filled in if not uploaded above)

Travelling arrangement(s)

Arrangements will be taken care of by the show committee (the show committee will consult the judge about the details and time schedule) Do you agree. If not please contact the show committee.

agreed

I will contact the committee

I will come accompanied (if yes please note that it will be at your own costs)

yes

The nearest airport is

Residence and date

Please enter your name again as this will be seen as your signature

Please upload copy of your passport or ID-card (to verify your name and for travelling arrangements)