NAL K IO EN T N A E N L

Overseas Judges Application Form N C A O

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T A Judging application for “Person Not a Resident of Australia” (Other than New Zealand residents) D

Application fee to be lodged by affiliate - payable to ANKC Ltd $50.00 (If lodged 9 months prior to the show) $100.00 (If lodged less than 9 months prior to the show) $10.00 (Additional fee if ANKC Ltd is required to obtain verification from overseas kennel club) The above fees are 10% GST inclusive

This form must be returned to the State/Territory ANKC Ltd Member Body for on-forwarding to the ANKC Ltd for approval.

PLEASE ENSURE ALL REQUESTED INFORMATION IS PROVIDED IN ENGLISH

Your details

Title Dr Mr Mrs Ms Miss

Full name

Date of birth Country of birth

Country of citizenship Country where qualifications were gained and are held

Contact details

Street name and number

Suburb State Postcode Country

Telephone Fax

Email

Other information

Business, profession or occupation Other Interests or hobbies

Page 1 Breed information

Please select the breed (s) for which you are approved to judge at Championship Show level in your country of residence, your original country of residence or the country of license. If that approval is provisional you will not be eligible to judge those breeds in Australia and you should not indicate them on the form.

GROUP 1 - TOYS GROUP 2 - GROUP 3 – GUNDOGS GROUP 4 -

Affenpinscher Airedale Afghan

Australian Silky Terrier American Hairless Terrier Azawakh

Bichon Frise American Staffordshire Terrier Chesapeake Bay Basenji

Cavalier King Charles Australian Terrier Basset Fauve de Bretagne

Chihuahua (Long Coat) Basset Hound

Chihuahua (Smooth Coat) Border Terrier Cocker Spaniel (American) Beagle

Chinese Crested Bull Terrier Curly Coated Retriever Black & Tan Coonhound

Coton De Tulear Bull Terrier (Miniature) English Bloodhound

English Toy Terrier (Black & Tan) Cairn Terrier Bluetick Coonhound

Griffon Bruxellois Cesky Terrier Borzoi

Havanese Dandie Dinmont Terrier Flat Coated Retriever (Long)

Italian Fox Terrier (Smooth) German Shorthaired Dachshund (Min. Long)

Japanese Chin Fox Terrier (Wire) German Wirehaired Pointer Dachshund (Smooth)

King Charles Spaniel German Hunting Terrier Dachshund (Min. Smooth)

Lowchen Glen of Imaal Terrier Dachshund (Wire)

Maltese Irish Terrier Hungarian Dachshund (Min. Wire)

Miniature Jack Russell Terrier Hungarian Deerhound

Papillon Kerry Blue Terrier Irish Red & White Setter Finnish Spitz

Pekingese Lakeland Terrier Foxhound

Pomeranian Grand Basset Griffon Vendeen

Pug Norfolk Terrier Italian Spinone Greyhound

Russian Toy (Smooth Haired) Norwich Terrier Hamiltonstovare

Russian Toy (Long Haired) Parson Russell Terrier Lagotto Romagnolo Harrier

Tibetan Spaniel Large Munsterlander Ibizan Hound

Yorkshire Terrier Sealyham Terrier Nova Scotia Duck Tolling Retriever Irish Wolfhound

Skye Terrier Pointer Norwegian Elkhound

Soft Coated Wheaten Terrier Spanish Otterhound

Staffordshire Bull Terrier Peruvian Hairless Dog (Large)

Tenterfield Terrier Peruvian Hairless Dog (Medium)

Welsh Terrier Weimaraner (Longhair) Peruvian Hairless Dog (Small)

West Highland White Terrier Petit Basset Griffon Vendeen

Wirehaired Slovakian Pointer Pharaoh Hound

Portuguese Podengo (Small)

Portuguese Podengo (Medium)

Portuguese Podengo (Large)

Rhodesian Ridgeback

Saluki

Sloughi

Whippet

Continued on next page.

Page 2 Breed information (continued)

GROUP 5 – WORKING GROUP 6 – UTILITY GROUP 7 – NON SPORTING BEST IN SHOW

Australian Cattle Dog Akita JUNIOR HANDLER

Australian Kelpie Akita (Japanese) British Bulldog

Australian Shepherd Canaan Dog

Australian Stumpy Tail Cattle Dog Anatolian Shepherd Dog Chow Chow

Bearded Collie Bernese Mountain Dog Dalmatian

Belgian Shepherd Dog (Groen)

Belgian Shepherd Dog (Laek) Bullmastiff

Belgian Shepherd Dog (Mal) Canadian Eskimo Dog (Klein)

Belgian Shepherd Dog (Terv) German Spitz (Mittel)

Bergamasco Shepherd Dog Caucasian Shepherd Dog

Border Collie Central Asian Shepherd Dog Japanese Spitz

Bouvier des Flandres

Briard Dogue de Bordeaux

Collie (Rough) Estrela Mountain Dog (Standard)

Collie (Smooth) Poodle (Miniature)

Dutch Shepherd Kangal Shepherd Dog Poodle (Toy)

Finnish Lapphund Landseer ECT Schipperke

German Shepherd Dog Shar Pei

German Shepherd Dog (LSC)

Icelandic Sheepdog Tibetan Terrier

Komondor Newfoundland Xoloitzcuintle (Miniature)

Kuvasz Xoloitzcuintle (Intermediate)

Maremma Sheepdog Pyrenean Mastiff Xoloitzcuintle (Standard)

Norwegian Buhund Pyrenean Mountain Dog

Old English Sheepdog

Polish Lowland Sheepdog Russian Black Terrier

Puli Samoyed

Pumi

Pyrenean Sheepdog Longhaired Schnauzer (Min.)

Shetland Sheepdog Schnauzer (Giant)

Swedish Lapphund Shiba Inu

Swedish Vallhund Siberian Husky

Tatra Shepherd Dog Spanish Mastiff

Welsh Corgi (Cardigan) St. Bernard

Welsh Corgi (Pembroke) Tibetan Mastiff

White Swiss Shepherd Dog

Page 3 Listing last amended: July 2018 More information

I am applying to judge in Australia the breed(s) as selected above for the following affiliate(s)

Proposed date of show(s)

Please list the breed(s) with which you have been involved as an owner and / or breeder and/or exhibitor

What other assignments are you currently contracted for in Australia or New Zealand?

Please give details of any previous judging assignments in Australia

Date Club Breeds/Group

What languages do you speak and read?

Have you ever been suspended from membership or had your judging approval cancelled by a Canine Controlling Body? If yes, please give details.

Declaration

I undertake to abide by the Rules and Regulations of the ANKC Ltd and judge to its approved Breed Standards. I declare all information on this form is correct and if circumstances make the information inaccurate I undertake to inform the ANKC Ltd forthwith. I will read the ANKC Ltd Breed Standards and its appropriate Member Body Regulations for Championship Shows and will judge to them. I also declare I am physically fit and capable of judging in the normally accepted manner. I understand that the ANKC Ltd may at its discretion disapprove this application.

Signature Date

Office use only Comments Date approved

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