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POPE AND YOUNG CLUB OFFICIAL MEASURER APPLICATION

First Name*

Last Name*

Member ID

Address

City*

State*

Zip

Email Address*

Phone Number*

Age*

Job Title

Date Of Birth

PLEASE INDICATE YOUR EXPERIENCE AND BACKGROUND IN MEASURING NORTH AMERICAN BIG GAME TROPHIES. INCLUDE REFERENCE TO AN ORGANIZATION FOR WHICH YOU CURRENTLY SERVE OR HAVE SERVED AS A MEASURER AND INCLUDE AN INDICATION OF THE LENGTH OF TIME YOU HAVE SERVED IN THIS CAPACITY

Have you ever attended a clinic on measuring big game?

If yes, please provide dates and clinic sponsor/leader

Have you ever been convicted of a game violation?*

If yes, please provide details

Have you ever been convicted of a criminal offense?*

If yes, please provide details

Reference #1 Name

Address

City

State

Zip

Phone

Reference #2 Name

Address

City

State

Zip

Phone

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