NOMINATION FORM

Selection criteria
> Regular participation in Pony Club rallies and activities
> Achievements in riding and completion of Pony Club certificates
> Demonstrated partnership with and care for their pony

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* 1. Pony Club ID (Member No.)

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* 2. Full name

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* 3. Date of Birth

Date

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* 4. Age at at 1/1/2020

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* 5. Club Name

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* 6. Supporting evidence that this rider regularly participates in Pony Club rallies and activities.

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* 7. Significant achievements made by this rider in both riding and completion of Pony Club certificates.

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* 8. How has this rider demonstrated partnership with and care for their pony?

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* 9. Nominating Person's Name

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* 10. How do you know the nominee?

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* 11. Do you hold an official posititon in Pony Club?

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* 12. What position do you hold?

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* 13. Need more space to explain why this nominee is worthy?  Upload your supporting evidence here!

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