Virginia Region Pony Clubs -
Club Rating Report – DISTRICT COMMISSIONER Please complete the following information and
forward it to the RS and RIC within 14 days of date of rating by fax or
email or mail. Thank you!
CLUB:
____________________________________ RATING DATE:
_____________________
EXAMINER:
_______________________________ FEE PAID: ________________
ASSISTANT(S):
_________________________ IMPARTIAL OBSERVER:________________________
DC
or CLUB REPRESENTATIVE PRESENT: ________________________________________________
NUMBER
OF CANDIDATES PER RATING LEVEL: D1: ___ D2 ___ D3___ C1 ___ C2 ___
NOTES
ABOUT RATING:
RATING STARTED ON
TIME: YES ___ NO ____
IF NO,
WHY NOT: ______________________________________________________________
LENGTH
OF RATING (if different for separate levels, please indicate):
__________________________
_____________________________________________________________________________________
OVERALL
EVALUATION OF SKILLS PREPARATION: ____________________________________ _____________________________________________________________________________________
CLUB WOULD BE WILLING TO
USE EXAMINER AGAIN (YES/NO): ___________
IF
NO, GIVE REASON WHY:
___________________________________________________________
OTHER
INFORMATION THAT MAY BE HELPFUL: _______________________________________
_____________________________________________________________________________________
(may
continue on back if necessary.)
ANY
SPECIAL CIRCUMSTANCES (weather, facility, horses, etc.): _____________________________
_____________________________________________________________________________________
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CANDIDATE NAME LEVEL PASSED RETEST
RETEST of
rating (Yes/No) (Yes,No) (What areas)
_____________________________ _______ _________ ________ _________________________
_____________________________ _______ _________ ________ _________________________
_____________________________ _______ _________ ________ _________________________
_____________________________ _______ _________ ________ _________________________
_____________________________ _______ _________ ________ _________________________
_____________________________ _______ _________ ________ _________________________
_____________________________ _______ _________ ________ _________________________
_____________________________ _______ _________ ________ _________________________
_____________________________ _______ _________ ________ _________________________
DC Signature:__________
__________________________________ Date: _________