Champion Loft Award Entry Form

Name:
Address:
Fly in Assn. with :
Loft Name : SUBMIT TO:
Awards Chairman
Walter Cichon
PO Box 436
West Islip, NY 11795
Phone: 631-422-0446
Email Pigeon0446@hotmail.com
Pres. Signature :  
Race Sec. Signature :  
Please enclose race results that go with these races.
Only Average Speed Races are permitted.
Send Race Schedule. OB 100, 200, 300, 400, 500.
YB (2) 100, (2) 200, (2) 300

This Entry Form must be signed by the Officer of the Organization you are submitting your race results for!
Combine results submitted; Combine officer’s signature required.
Club results submitted; Club officer’s signature required.

DATE OF RACEDISTANCE OF RACETOTAL # OF LOFTS IN RACE TOTAL # OF BIRDS IN RACEPOSITION# OF BIRDS SENT BY YOUR LOFTWINNER'S SPEEDYOUR BEST SPEED

To receive a copy of your submission please enter email here.