KEYSTONE HOLSTEIN FUTURITY FOR 3-YEAR-OLDS
1st payment 2nd payment 3rd payment
Futurity Fee Schedule
NOTE: A SEPARATE FORM IS REQUIRED FOR EACH EXHIBITOR
Make check payable to Pennsylvania Holstein Assn. 839 Benner Pike, State College PA 16801 ENTRY FORM Please Type or Print Clearly
Exhibitor (must be owner)
March 31, 2018 $3/animal September 15, 2018 $11/animal September 15, 2019 $20/animal
I, ________________________________________ (Signature, Owner or Authorized Agent)
City
in submitting these entries commit myself to the rules and regulations, including the PDCA Code of Ethics, of the Keystone Holstein Futurity, and the PA Holstein Show program
State/Zip
Date
Address (Street)
Telephone
ENTRY NO. 1.
INFORMATION ON ENTRY Name
Registry Number 2.
Name
Registry Number 3.
DOB
Name
Registry Number 5.
DOB
Name
Registry Number 4.
DOB
DOB
Name
Registry Number
SPECIAL INSTRUCTIONS: 1. READ CAREFULLY the rules as they Appear in this issue.
DOB
SIRE AND DAM
BREEDER & ADDRESS from Reg. Certificate
S.
Breeder
D.
Address
S.
Breeder
D.
Address
S.
Breeder
D.
Address
S.
Breeder
D.
Address
S.
Breeder
D.
Address
2. INDIVIDUAL ANIMALS – fill in all spaces for each animal. If additional space is needed please use a plain sheet of paper With the same information as requested above.
3. ENTRY FORMS – must be signed by owner or authorized agent.
_______ ANIMALS ENTERED $___________TOTAL ENTRY FEE