National Land & Range Judging Contest
 Registration & Certification Form
May 5-7, 2009
Oklahoma City, Oklahoma
Oklahoma Association of Conservation Districts (OACD)
4850 N. Lincoln Blvd, Ste B
Oklahoma City, OK  73105-3326
District Phone:  405-524-4450
NRCS Phone: 405-521-1332                 Fax: 405-521-1461                         e-mail: oklahomaccd@conservation.ok.gov

     Division (check one)
 FFA
4-H

             Contest (check one)
Land (only)   
Homesite (only)		 Land & Homesite     
Range

Please complete and send $100 Team registration fee and/or an additional $25 each for contestants competing as individuals.

fill in the blanks on your computer first; then print the form and mail
                   if you print the form before you fill in the blanks, please make sure names are legible

Instructor/Coach  

Chapter/Club   Phone

Address: Street or Box 

City State   Zip

email address

Team Members                                             
1. date of birth
2. date of birth
3. date of birth
4. date of birth

I certify that the team members are eligible to represent our state and that they have not previously participated in the National Land or Homesite Judging Contest or have been on a first place team or high individual in the Range Contest as either a FFA or 4-H contestant.

_____________________________________________ Date: _______________
State FFA Official          or           State 4-H Official

(5 Manuals will be sent upon receipt of registration form)
official use only:

check #:                                     team #:
date: