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Form 195(rev-2M-3-02) LIVESTOCK EXHIBIT ENTRY FORM 20 ____ Market Animal Number Circle One: Beef Dairy Sheep Hogs Commercial Heifer Circle One: Breeding Market Circle One: ______________________________________________ Exhibitor's Name (Print or Type) Goat Dairy Goat 4-H FFA Adult _________________________ Exhibitor's Birthdate ______________________________________________________________________________ PO Box, Street and Number, or RFD City, Zip Code Exhibitor Certification Number _____________________ Showmanship (circle one) YES or NO Premier Exhibitor (Circle one) YES or NO Name of Breed __________________________ Lot No. __________ Class No. __________ Complete for Registered Animals: Date of Birth: _________________________ Sex __________________ Name of Animal ________________________________ Registry No. ____________________ For Office use Only: Weight ____________ ____________ __________ County District State Placing ____________ __________ County District _________ State I agree to abide by the rules as published in the applicable catalog. ______________________________________ Extension 4-h Agent or Agriculture Teacher Signature ________________________________ Exhibitor's Signature _________________________________ or ________________________________________ 4-h Entry -- Name of County and Number FFA Entry -- Name of County and School Mailing Address