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Signature:","type":"control_textbox"},null,null,null,{"name":"date","qid":"56","text":"Date:","type":"control_textbox"},{"name":"submit","qid":"57","text":"Submit","type":"control_button"},null,{"name":"regularStatus","qid":"59","text":"Regular Status Tracking Judging Request","type":"control_head"},null,null,null,{"description":"","name":"completedAssignments","qid":"63","text":"Completed Assignments (for the level in which you are applying):","type":"control_matrix"},{"name":"iCertify","qid":"64","text":"I certify that I understand and acknowledge that if I am charged with cruelty, inhumane treatment of animals, or similar offenses involving inhumane or cruel treatment of dogs, or charged with any crime involving moral turpitude, especially as it concerns dog-related activities, the AKC may temporarily place my judging privileges on referral while the charges are pending. Further, after receiving notification of the referral, I am prevented from judging or from accepting assignments to judge. When the charges are resolved and AKC's inquiry into the matter determines that no action will be taken by the AKC to cause a suspension of my judging privileges, the temporary judging referral will be removed.\n\"I certify that I am a member in good standing with the American Kennel Club, 21 years of age or older, and that all information submitted in this application is truthful and accurate.\"","type":"control_text"},{"description":"","labelText":"","name":"warningtext6255c8a52af3e902782477","qid":"65","text":"warningtext.6255c8a52af3e9.02782477","type":"control_image"},{"name":"input66","qid":"66","text":"Under the provisional system, you are eligible to accept an unlimited number of assignments at the test level you are approved to judge.聽\nTo submit a request for Regular Status for Tracking Dog and Tracking Dog Urban (TD\u002FTDU), submit this completed form after you have judged a minimum of six (6) TD\u002FTDU tests with at least three (3) different judges, none of which may be a spouse. In addition, a satisfactory observation judging at this provisional test level must have been conducted within two years of this request, or a minimum of three (3) positive co-judge聽Tracking Judge Evaluations must be received. The Companion Events Judging Approval Committee will review your judging records and you will be notified of the Committee鈥檚 action.\n聽\nTo submit a request for Regular Status Tracking Dog Excellent (TDX),聽submit this completed form after you have judged a minimum of six (6) TDX tests with at least three (3) different judges, none of which may be a spouse. In addition, a satisfactory observation judging at the provisional level must have been conducted within two years of this request, or a minimum of three (3) positive co-judge Tracking Judge Evaluations. 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In addition, a satisfactory observation judging at this provisional test level must have been conducted within two years of this request, or a minimum of three (3) positive co-judge聽Tracking Judge Evaluations must be received. The Companion Events Judging Approval Committee will review your judging records and you will be notified of the Committee鈥檚 action.</p> <p>聽</p> <p><strong>To submit a request for Regular Status Tracking Dog Excellent (TDX),聽</strong>submit this completed form after you have judged a minimum of six (6) TDX tests with at least three (3) different judges, none of which may be a spouse. In addition, a satisfactory observation judging at the provisional level must have been conducted within two years of this request, or a minimum of three (3) positive co-judge Tracking Judge Evaluations. The Companion Events Judging Approval Committee will review your judging records and you will be notified of the Committee鈥檚 action.</p> <p>聽</p> <p><strong>To submit a request for Regular Status Variable Surface Tracking (VST)</strong>, submit this completed form after you have judged a minimum of three (3) VST tests with at least three (3) different judges, none of which may be a spouse. In addition, a satisfactory observation judging at the provisional level must have been conducted within two years of this request, or a minimum of three (3) positive co-judge Tracking Judge Evaluations. The Companion Events Judging Approval Committee will review your judging records and you will be notified of the Committee鈥檚 action.</p> </div> </div> </li> <li class="form-line jf-required" data-type="control_textbox" id="id_2"><label class="form-label form-label-top form-label-auto" id="label_2" for="input_2" aria-hidden="false"> Judge Number:<span class="form-required">*</span> </label> <div id="cid_2" class="form-input-wide jf-required" data-layout="half"> <input type="text" id="input_2" name="q2_judgeNumber" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_2" required="" value="" /> </div> </li> <li class="form-line jf-required" data-type="control_fullname" id="id_70"><label class="form-label form-label-top form-label-auto" id="label_70" for="first_70" aria-hidden="false"> Name<span class="form-required">*</span> </label> <div id="cid_70" class="form-input-wide jf-required" data-layout="full"> <div data-wrapper-react="true"><span class="form-sub-label-container" style="vertical-align:top" data-input-type="first"><input type="text" id="first_70" name="q70_name[first]" class="form-textbox validate[required]" data-defaultvalue="" autoComplete="section-input_70 given-name" size="10" data-component="first" aria-labelledby="label_70 sublabel_70_first" required="" value="" /><label class="form-sub-label" for="first_70" id="sublabel_70_first" style="min-height:13px">First Name</label></span><span class="form-sub-label-container" style="vertical-align:top" data-input-type="last"><input type="text" id="last_70" name="q70_name[last]" class="form-textbox validate[required]" data-defaultvalue="" autoComplete="section-input_70 family-name" size="15" data-component="last" aria-labelledby="label_70 sublabel_70_last" required="" value="" /><label class="form-sub-label" for="last_70" id="sublabel_70_last" style="min-height:13px">Last Name</label></span></div> 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id="sublabel_71_addr_line1" style="min-height:13px">Street Address</label></span></span></div> <div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_71_addr_line2" name="q71_address71[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autoComplete="section-input_71 address-line2" data-component="address_line_2" aria-labelledby="label_71 sublabel_71_addr_line2" value="" /><label class="form-sub-label" for="input_71_addr_line2" id="sublabel_71_addr_line2" style="min-height:13px">Street Address Line 2</label></span></span></div> <div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_71_city" name="q71_address71[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autoComplete="section-input_71 address-level2" data-component="city" aria-labelledby="label_71 sublabel_71_city" required="" value="" /><label class="form-sub-label" for="input_71_city" id="sublabel_71_city" style="min-height:13px">City</label></span></span><span class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_71_state" name="q71_address71[state]" class="form-textbox validate[required] form-address-state" data-defaultvalue="" autoComplete="section-input_71 address-level1" data-component="state" aria-labelledby="label_71 sublabel_71_state" required="" value="" /><label class="form-sub-label" for="input_71_state" id="sublabel_71_state" style="min-height:13px">State / Province</label></span></span></div> <div class="form-address-line-wrapper jsTest-address-line-wrapperField"><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_71_postal" name="q71_address71[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autoComplete="section-input_71 postal-code" data-component="zip" aria-labelledby="label_71 sublabel_71_postal" required="" value="" /><label class="form-sub-label" for="input_71_postal" id="sublabel_71_postal" style="min-height:13px">Postal / Zip Code</label></span></span></div> </div> </div> </li> <li class="form-line form-line-column form-col-1 jf-required" data-type="control_phone" id="id_72"><label class="form-label form-label-top" id="label_72" for="input_72_full"> Phone Number<span class="form-required">*</span> </label> <div id="cid_72" class="form-input-wide jf-required" data-layout="half"> <span class="form-sub-label-container" style="vertical-align:top"><input type="tel" id="input_72_full" name="q72_phoneNumber[full]" data-type="mask-number" class="mask-phone-number form-textbox validate[required, Fill Mask]" data-defaultvalue="" autoComplete="section-input_72 tel-national" style="width:310px" data-masked="true" placeholder="(000) 000-0000" data-component="phone" aria-labelledby="label_72 sublabel_72_masked" required="" value="" /><label class="form-sub-label" for="input_72_full" id="sublabel_72_masked" style="min-height:13px">Please enter a valid phone number.</label></span> </div> </li> <li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_11"><label class="form-label form-label-top" id="label_11" for="input_11" aria-hidden="false"> Email:<span class="form-required">*</span> </label> <div id="cid_11" class="form-input-wide jf-required" data-layout="half"> <input type="text" id="input_11" name="q11_email" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_11" required="" value="" /> </div> </li> <li class="form-line jf-required" data-type="control_matrix" id="id_63"><label class="form-label form-label-top form-label-auto" id="label_63" for="input_63" aria-hidden="false"> Completed Assignments (for the level in which you are applying):<span class="form-required">*</span> </label> <div id="cid_63" class="form-input-wide jf-required" data-layout="full"> <table summary="" role="table" aria-labelledby="label_63" cellPadding="4" cellSpacing="0" class="form-matrix-table" data-component="matrix"> <tr class="form-matrix-tr form-matrix-header-tr"> <th class="form-matrix-th" style="border:none">聽</th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_0"><label id="label_63_col_0">Complete Club Name (no initials)</label></th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_1"><label id="label_63_col_1">Date</label></th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_2"><label id="label_63_col_2">Number of Dogs Judged</label></th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_3"><label id="label_63_col_3">Co-Judge Name</label></th> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_63 label_63_row_0"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_63_row_0">1.</label></th> <td class="form-matrix-values"><input id="input_63_0_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_0 label_63_row_0" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_0_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_1 label_63_row_0" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_0_2" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_2 label_63_row_0" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_0_3" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_3 label_63_row_0" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_63 label_63_row_1"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_63_row_1">2.</label></th> <td class="form-matrix-values"><input id="input_63_1_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[1][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_0 label_63_row_1" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_1_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[1][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_1 label_63_row_1" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_1_2" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[1][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_2 label_63_row_1" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_1_3" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[1][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_3 label_63_row_1" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_63 label_63_row_2"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_63_row_2">3.</label></th> <td class="form-matrix-values"><input id="input_63_2_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[2][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_0 label_63_row_2" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_2_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[2][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_1 label_63_row_2" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_2_2" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[2][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_2 label_63_row_2" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_2_3" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[2][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_3 label_63_row_2" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_63 label_63_row_3"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_63_row_3">4.</label></th> <td class="form-matrix-values"><input id="input_63_3_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[3][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_0 label_63_row_3" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_3_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[3][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_1 label_63_row_3" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_3_2" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[3][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_2 label_63_row_3" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_3_3" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[3][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_3 label_63_row_3" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_63 label_63_row_4"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_63_row_4">5.</label></th> <td class="form-matrix-values"><input id="input_63_4_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[4][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_0 label_63_row_4" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_4_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[4][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_1 label_63_row_4" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_4_2" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[4][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_2 label_63_row_4" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_4_3" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[4][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_3 label_63_row_4" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_63 label_63_row_5"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_63_row_5">6.</label></th> <td class="form-matrix-values"><input id="input_63_5_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[5][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_0 label_63_row_5" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_5_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[5][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_1 label_63_row_5" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_5_2" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[5][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_2 label_63_row_5" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_5_3" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[5][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_3 label_63_row_5" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_63 label_63_row_6"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_63_row_6">7.</label></th> <td class="form-matrix-values"><input id="input_63_6_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[6][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_0 label_63_row_6" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_6_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[6][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_1 label_63_row_6" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_6_2" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[6][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_2 label_63_row_6" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_6_3" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[6][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_3 label_63_row_6" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_63 label_63_row_7"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_63_row_7">8.</label></th> <td class="form-matrix-values"><input id="input_63_7_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[7][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_0 label_63_row_7" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_7_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[7][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_1 label_63_row_7" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_7_2" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[7][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_2 label_63_row_7" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_63_7_3" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q63_completedAssignments[7][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_63_col_3 label_63_row_7" aria-label="Cells Text Box" value="" /></td> </tr> </table> </div> </li> <li class="form-line jf-required" data-type="control_dropdown" id="id_47"><label class="form-label form-label-top form-label-auto" id="label_47" for="input_47" aria-hidden="false"> Have you received an observation from an AKC Field Representative for the level in which you are applying?<span class="form-required">*</span> </label> <div id="cid_47" class="form-input-wide jf-required" data-layout="half"> <select class="form-dropdown validate[required]" id="input_47" name="q47_haveYou" style="width:150px" data-component="dropdown" required="" aria-label="Have you received an observation from an AKC Field Representative for the level in which you are applying?"> <option value="">Please Select</option> <option value="Yes">Yes</option> <option value="No">No</option> </select> </div> </li> <li class="form-line" data-type="control_matrix" id="id_69"><label class="form-label form-label-top form-label-auto" id="label_69" for="input_69" aria-hidden="false"> List All Observation/Evaluations (for the level in which you are applying): </label> <div id="cid_69" class="form-input-wide" data-layout="full"> <table summary="" role="table" aria-labelledby="label_69" cellPadding="4" cellSpacing="0" class="form-matrix-table" data-component="matrix"> <tr class="form-matrix-tr form-matrix-header-tr"> <th class="form-matrix-th" style="border:none">聽</th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_0"><label id="label_69_col_0">Name of <br />Field Representative <br /> or Co-Judge Evaluator</label></th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_1"><label id="label_69_col_1">Date</label></th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_2"><label id="label_69_col_2">Class</label></th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_3"><label id="label_69_col_3">Number of Dogs</label></th> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_69 label_69_row_0"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_69_row_0">1.</label></th> <td class="form-matrix-values"><input id="input_69_0_0" class="form-textbox" type="text" size="5" name="q69_listAll[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_0 label_69_row_0" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_0_1" class="form-textbox" type="text" size="5" name="q69_listAll[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_1 label_69_row_0" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_0_2" class="form-textbox" type="text" size="5" name="q69_listAll[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_2 label_69_row_0" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_0_3" class="form-textbox" type="text" size="5" name="q69_listAll[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_3 label_69_row_0" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_69 label_69_row_1"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_69_row_1">2. </label></th> <td class="form-matrix-values"><input id="input_69_1_0" class="form-textbox" type="text" size="5" name="q69_listAll[1][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_0 label_69_row_1" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_1_1" class="form-textbox" type="text" size="5" name="q69_listAll[1][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_1 label_69_row_1" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_1_2" class="form-textbox" type="text" size="5" name="q69_listAll[1][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_2 label_69_row_1" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_1_3" class="form-textbox" type="text" size="5" name="q69_listAll[1][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_3 label_69_row_1" aria-label="Cells Text Box" value="" /></td> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_69 label_69_row_2"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_69_row_2">3. </label></th> <td class="form-matrix-values"><input id="input_69_2_0" class="form-textbox" type="text" size="5" name="q69_listAll[2][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_0 label_69_row_2" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_2_1" class="form-textbox" type="text" size="5" name="q69_listAll[2][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_1 label_69_row_2" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_2_2" class="form-textbox" type="text" size="5" name="q69_listAll[2][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_2 label_69_row_2" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_69_2_3" class="form-textbox" type="text" size="5" name="q69_listAll[2][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_69_col_3 label_69_row_2" aria-label="Cells Text Box" value="" /></td> </tr> </table> </div> </li> <li class="form-line jf-required" data-type="control_matrix" id="id_81"><label class="form-label form-label-top form-label-auto" id="label_81" for="input_81" aria-hidden="false"> List required AKC Judges' Education classes/webinars you have completed in last three years.<span class="form-required">*</span> </label> <div id="cid_81" class="form-input-wide jf-required" data-layout="full"> <table summary="" role="table" aria-labelledby="label_81" cellPadding="4" cellSpacing="0" class="form-matrix-table" data-component="matrix"> <tr class="form-matrix-tr form-matrix-header-tr"> <th class="form-matrix-th" style="border:none">聽</th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_0"><label id="label_81_col_0">Date Completed</label></th> <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_1"><label id="label_81_col_1">Comments/Specifics</label></th> </tr> <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_81 label_81_row_0"> <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_81_row_0">AKC Stewards of Children</label></th> <td class="form-matrix-values"><input id="input_81_0_0" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q81_listRequired[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_81_col_0 label_81_row_0" aria-label="Cells Text Box" value="" /></td> <td class="form-matrix-values"><input id="input_81_0_1" class="form-textbox validate[required, requireOneAnswer]" type="text" size="5" name="q81_listRequired[0][]" style="width:100%;box-sizing:border-box" aria-labelledby="label_81_col_1 label_81_row_0" aria-label="Cells Text Box" value="" /></td> </tr> </table> </div> </li> <li class="form-line" data-type="control_text" id="id_64"> <div id="cid_64" class="form-input-wide" data-layout="full"> <div id="text_64" class="form-html" data-component="text" tabindex="-1"> <p>I certify that I understand and acknowledge that if I am charged with cruelty, inhumane treatment of animals, or similar offenses involving inhumane or cruel treatment of dogs, or charged with any crime involving moral turpitude, especially as it concerns dog-related activities, the AKC may temporarily place my judging privileges on referral while the charges are pending. Further, after receiving notification of the referral, I am prevented from judging or from accepting assignments to judge. When the charges are resolved and AKC's inquiry into the matter determines that no action will be taken by the AKC to cause a suspension of my judging privileges, the temporary judging referral will be removed.</p> <p>"I certify that I am a member in good standing with the American Kennel Club, <strong>21</strong> years of age or older, and that all information submitted in this application is truthful and accurate."</p> </div> </div> </li> <li class="form-line jf-required" data-type="control_textbox" id="id_52"><label class="form-label form-label-top form-label-auto" id="label_52" for="input_52" aria-hidden="false"> I certify that this electronic typed signature, sent via email, shall serve as my official signature. 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