rider achievement award form

Rider Achievement Award Form

Qualified scores, when reported on this Rider Achievement Award Report, will apply toward WNYDA Rider Achievement Awards. Print and copy form as needed. Return this form to the WNYDA Scorekeeper by September 15 of the competition year

PRINT, COMPLETE AND MAIL TO: WNYDA SCOREKEEPER

c/o Peggy Polisseni
5185 E. Henrietta Road
Henrietta, NY 14467

Rider
Street Address
City, State, Zip
Competition Name
Competition Date

LEVEL	JUDGE(S)	SCORE	%

SUBMIT SCORES AS SOON AS POSSIBLE FOLLOWING THE COMPETITION TO ASSURE ACCURACY.
Do not send copies of tests

I hereby attest to the authenticity of the above scores
MUST BE SIGNED BY SHOW SECRETARY

_________________________________________________________
Signature of Show Secretary Date

Riders are responsible for notifying the WNYDA score keeper of their scores to be eligible for the WNYDA Rider Achievement Awards!