Animal's Name:

Registration #:

Breed Sex:

Animal D.O.B:

Tattoo:

Nominator Name:

Herd Name:

Nominator Address: Street

City State Zip

Nominator Phone:

Hold Price (if any)

Is the nominee being raised/managed on CAE prevention program?

Is herd tattoo registered with either the voluntary or mandatory USDA Scrapie Program?

*Use the additional space to attach photographs of nominee front, side and rear views (required) Please indicate the age at which the photo of the nominee was taken. You may submit a photo taken later for use in advertisements if your animal is chosen for consignment.

*Send ADGA Registration and Pedigree Sheet (required) You may attach two more sheets for information pertaining to dam, sire, and/or other relatives, including show wins, milk records, HES or LA scores, or any other information you deem pertinent to the strength of your nominee.

*You must be the breeder of the animal being nominated, OR have a signed letter from ADGA stating that you are on the breeders signature card and may act as their agent.

*A consignment form will be sent to you if your nominee is selected, at which time you will also be charged a $20.00 consignment fee to help defray the cost of adverstising. This form must be returned by the deadline on the form, or an alternate nominee will be entered by the Buckeye Sale committee.

Use up to two pages to add information on the relatives of your nominee. The more information you provide the better the animal can be marketed should it be consigned. Please do not exceed these two extra pages. The ADGA registration & pedigree page does not count. You may submit a total of 5 pages of information.

Entries must be received by July 10, 2010.