Southeastern New England Region

USPC

WORK STUDY PROGRAM

DC Request Form

DC Name

Pony Club

Address

City State Zip

Home Phone: E-Mail:

Please complete both sides of this form and return it at least 3 to 4 weeks prior to your activity, to:

Debbie Stewart

60 Warren St.

Plainville, MA 02762

Phone & Fax: (508) 695-3904 E-Mail: dstewart@jpstewart.com

:

I would like to request a Work Study Candidate to help with the following activity:

Rallies:

Fill in the Rally level (D1, D2, D3, Cl, C2) and the Date/Dates needed:

Level_____Know Down Date(s)__________________________________

Level_____Show Jumping Date(s)__________________________________

Level_____Dressage Date(s)__________________________________

Level_____Tetrathalon Date(s)__________________________________

Level_____Games Date(s)__________________________________

Level_____Combined Training Date(s)__________________________________

Level_____Polocrosse Date(s)__________________________________

Level_____Vaulting Date(s)__________________________________

Level_____Horse Mgt. Assistant # needed_____Date(s)_____________________

Clinics:

Level_____Bandaging Date(s)__________________________________

Level_____Conformation Date(s) _________________________________

Level_____Longeing Date(s)__________________________________

Level_____Conditioning Date(s)__________________________________

Level_____Lameness Date(s)__________________________________

Level_____Feeds & Feeding Date(s)__________________________________

Level_____Ratings Prep Date(s)__________________________________

Level_____Mock Rally Date(s)__________________________________

Level_____Other Date(s)__________________________________

I would like to request the following candidate(s):__________________________

__________________________________________________________________