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THE POLISH LOWLAND SHEEPDOG CLUB OF WALES and THE WEST OF ENGLAND

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Polish Lowland sheepdog Basic Working Tests

Directions to Langley Burrell Village Hall

Judges List Questionnaire 2015

Health Survey a 2016

Judges application new applicant 2015

Membership Form

 

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The Polish Lowland Sheepdog Club of Wales & the West of England

        Judges List 2015 Questionnaire

Abbreviated questionnaire to be completed and submitted to the Judges Sub Committee, prior to 1st November 2014, by all judges currently on the PLSCWWE list, EXCEPT List A1.

The Judges List of The Polish Lowland Sheepdog Club of Wales & the West of England is prepared annually by the Judges Sub Committee based on the application forms submitted prior to the above date.
  **Please complete shaded areas only**

Title: (Mr/Mrs/Miss/Ms/Dr)

 

Full Name:

 

Address

 

Postcode

 

Telephone Number

 

Email Address

 

Affix

 

Please give details below for any PLS judging appointments completed since you last submitted an application form.

Date

Name of show

Type of show

No. of classes judged

No of dogs present & judged

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please give details below for any PLS specific seminars successfully completed since you last submitted an application form

Date

Organised By

Details

 

 

 

 

 

 

 

 

 

Please give details of stewarding experience:

1

 

5

 

9

 

2

 

6

 

10

 

3

 

7

 

11

 

4

 

8

 

12

 

Please give details of all future, confirmed appointments to judge PLS. If no future appointments please give last appointment judged

This list enables us to provide all circulated societies with the maximum possible information

Date:

Show:

 

 

 

 

 

 

 

 

DECLARATION
(To be completed and signed by all applicants. E-mail submissions will be accepted as if signed)

The submission of a completed form does not necessarily ensure inclusion in the Club’s lists

Lists will only be valid for one year at a time and inclusion on a list in one year does not necessarily ensure inclusion in future years.

I guarantee to do a written critique for submission to the Dog Press within one month of the judging appointment. I certify that all the information I have given on this application form, is a true and accurate record.

Signature


 

Date

 

COMPLETED FORMS TO BE RETURNED BY 1st November 2014 TO

Terrie Cousins-Brown
Morawel
Middleton
Rhossili
Swansea
SA3 1PJ

Telephone: 01792 390586
e-mail: terrie.plscwwe@mail.com

 

POLISH LOWLAND SHEEPDOG CLUB OF WALES AND WEST OF ENGLAND

GENERAL HEALTH SURVEY  2013-2014

 

Owner /s____________________________

Address________________________________________________________________________________________

______________________________________________________________

Post Code_______________________________

Email address________________________________

Telephone Number ( if no email address)

Name of PON _____________________________________________
& pet name_______________________________________

Date of Birth___________________________ Male /Female  ___________________________________

Breeder______________________________________

Sire____________________________________ 

Dam _________________________________________-

Has your  PON had any significant medical condition or injury ?

Could you say if the condition has been diagnosed and treated by a Veterinarian  or other therapist & could you give details and approximate dates?

 

 

Is your PON on any treatment now? 

Could you give the details of any illnesses or injuries and treatment your PON has had since 1st January 2014

 

Has  your PON have any other condition/s  which you haven’t needed to consult a Vet  eg behaviour problems, itches,  lumps

 

Could you give the dates & details of any vaccinations or worming  your PON has had since 1st January 2012 and whether there were any reactions

Has your PON had any routine tests  such as hip scoring, eye test?  Could you give the results? 

 

What is the predominant diet of your PON  eg Complete food,  Dry, Barf, Vegetarian

How active does your PON keep you  eg walks, agility, good citizens.

Is there anything else you would like to add?