Registered Champion Certificate Entry Form
Please type or BLOCK-LETTER the following spaces so that we will get your
name, etc., correct. Forms also available on line at www.ifpigeon.com
I, of Street, City of
and State of Zip do hereby submit to my Club Secretary for verification and completion of this application for a REGISTERED CHAMPION BIRD AWARD. Banded Name if any owned and flown by me.
Date Signed Record of Diploma Performance
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.In a waiver of an officer’s signature please submit the officer contact information and inform him, he will be contacted, in regards to this award
Club Secretary’s Calculation of Points
Registered Champion Chairperson
309 Green Avenue
Lyndhurst, NJ 07071
Phone: (201) 939-3142