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Mock Test & Training Day Registration Saturday, September 4th @ 8:00am (Rain or Shine) hosted by Jeff Henke & Bobbi Benson 6442 - 114th Avenue Wapello, IA 52653 LAT 41.14552° LONG -91.144289° [Directions] The Mock Test is open to everyone registered for the Western Illinois Chapter's Fall Test and all Chapter Members. For those testing this Fall, this will be a good opportunity to work on the areas of the Test you feel you need to go over. Even if not testing, Chapter Members are welcome to participate, as this is also a Training Day. Registration is required to participate. To register, complete and submit the Registration Form below no later than Thursday, September 2nd. A registration fee equal the cost of birds procurred by the Western Illinois Chapter for your use will be due when you arrive at the Mock Test & Training Day. If you plan to run multiple dogs, please submit a separate Registration Form for each dog. Thank you! Handler Information Handler's Name: [required] Home Phone: [required] Cell Phone: Email Address: [required] Mailing Address: [required] Testing Dog Information Registered Name: [required] Call Name: [required] Breed: Select Bracco Italiano Braque D’auvergne Braque Du Bourbonnais Braque Francais Brittany Cesky Fousek Drentse Partridge English Setter French Spaniel German Longhaired Pointer German Shorthaired Pointer German Wirehaired Pointer Gordon Setter Irish Red & White Setter Irish Setter Large Munsterlander Pointer Portuguese Pointer Pudelpointer Slovensky Hrubosrsty Stavac Small Munsterlander Spinone Stichelhaar Vizsla Weimaraner Wirehaired Pointing Griffon Wirehaired Vizsla [required] Mock Test Information I want to train this Test: Natural Ability   Utility Preparatory   Utility I want to train these portions of the Natural Ability Test: Field Search (select birds to be used):        3 Quail @ $9        1 Chukar, 2 Quail @ $13        2 Chukar, 1 Quail @ $17        3 Chukar @ $21 Pheasant Track @ $9 Water (swimming) I want to train these portions of the Utility Preparatory Test: Field Search (select birds to be used):        3 Quail @ $9        1 Chukar, 2 Quail @ $13        2 Chukar, 1 Quail @ $17        3 Chukar @ $21 Steadiness at Blind & Retrieve of Duck @ $10 Walking at Heel Retrieve (Duck) by Drag @ $10 Water (Duck) Search @ $10 I want to train these portions of the Utility Test: Field Search (select birds to be used):        3 Quail @ $9        1 Chukar, 2 Quail @ $13        2 Chukar, 1 Quail @ $17        3 Chukar @ $21 Steadiness at Blind & Retrieve of Duck @ $10 Walking at Heel Retrieve (Duck) by Drag @ $10 Water (Duck) Search @ $10 Order Extra Training Birds (Quail @ $3/ea; Chukar @ $7/ea; Pheasant @ $9/ea; Ducks @ $10/ea): Additional Information/Questions: I understand I am responsible for the cost of birds procurred by the Western Illinois Chapter on my behalf. I know I must cancel or make changes to my registration before midnight on September 2nd, or I will be financially responsible for the full cost. I agree to pay the registration fee when I arrive at the Mock Test & Training Day. Should I not attend, I understand I will be billed for the registration fee, which I promise to pay.

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