Field Trial Organization Name:

Contact Person's Name:

Contact Person's Address:

City:

State:

Zip:

Email Address:

Work Phone:

(       )

Home Phone:

(       )

Fax Number:

(       )

Cell Phone:

(       )

Dates of Field Trials:

Location of Field Trial:

  Des Plaines CA

  Pyramid SP − Captain Unit

  Jim Edgar Panther Creek SFWA

  Pyramid SP − Denmark Unit

  Hamilton Co. SFWA

  Pyramid SP − Galum Unit

  Moraine View SP

  Wayne Fitzgerrell SP

  Middle Fork SFWA

  Other

Type of Field Trial:

  Pointing Dog − Horseback

  Retriever

  Pointing Dog − Walking

  Flushing Dog − Shoot-To-Retrieve

  Pointing Dog − Shoot-To-Retrieve

  English Springer Spaniel

  Beagle Hound

  Fox Hound

  Coon Hound

  Other

Licensing or Sanctioning Sporting Dog Registry or Association if Applicable:

  American Kennel Club (AKC)

  American Rabbit Hound Association (ARHA)

  National Shoot-To-Retrieve Field Trial Association (NSTRA)

  United Kennel Club (UKC)

  The American Field – Field Dog Stud Book (AFDSB)

  Amateur Field Trial Clubs of America (AFTCA)

  National Kennel Club (NKC)

  Professional Kennel Club (PKC)

  Club Sponsored Event

Request must be received at least four weeks prior to the date of the field trail.

Fees:    Pointing Breed, Horseback Fox Hound, Retrieving Breed and Flushing Breed Field Trials − $70 per day

Beagle and Coon Hound Field Trials − $25 per day

A current certificate of liability insurance valid for the dates of the field trial must either be on file with DNR or attached to this application.

Submit application to: IDNR, Attention: Field Trial Program, One Natural Resources Way, Springfield IL 62702-1271; Phone:  (217)782-6752; Fax:  (217)524-5612