2018 New England 4-H Dog Steward Program at THE BIG E Entry Form
This entry is made in accordance with the rules and regulations governing this program
PLEASE ENTER ALL INFORMATION AND COMPLETE EVERY LINE
Steward Last Name *
Your answer
Steward First Name *
Your answer
Club Name *
(write "independent" if not part of a club)
Your answer
Mail Address *
Your answer
Town/City *
Your answer
State *
Your answer
State Representing *
Your answer
Zip Code *
Your answer
Telephone # *
Your answer
E-mail Address *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Gender *
Is this your last eligible year? *
Any Stewarding experience? *
Required
If yes, Number of 4-H Shows *
Your answer
If yes, Number of AKC Shows *
Your answer
Number of years with any and all dog showmanship experience *
Include this year
Your answer
Breed of Dog Shown *
Your answer
What level of showmanship do you show in?
Note: Division I designates ages 12-14; Division II designates ages 15-19. Ages are determined as of January 1
Division I *
Select one of the following (designates ages 12-14)
Division II *
Select one of the following (designates ages 15-19. Ages determined as of January 1)
Would you like to participate in a quiz bowl team not affiliated with a particular state? *
Required
Are you planning to participate in Meet the Breed? *
Required
Do you require a reader to assist you with the Dog Knowledge Quiz? *
Required
Please note if the 4-H member need any special accommodations in order to participate in this program (Physical accommodations, test accommodations, allergy safe, etc.). *
Your answer
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