MIT Figure Skating Club
U.S. Figure Skating Test Session Application
Test Date: ______________________________________
Name: ______________________________________
Email Address: ______________________________________
Phone Number: ______________________________________
U.S. Figure Skating
Member #:
Test(s) to be taken: ______________________________________
Coach's Signature: ______________________________________
U.S. Figure Skating
Home Club:
Permission from
Home Club (if not MIT):
Address of Home Club
Test Chair (if not MIT):
U.S. Figure Skating
Test Fees:
$3 per test
Judges Hospitality
& Transportation:
$10 if taking 1 test OR
$15 if taking 2 or more tests
Total: ______________________________________
Please make check payable to MIT Figure Skating Club
NOTE: By the terms of our ice usage agreement with MIT,
you must be a member of the MIT Figure Skating Club to test
at our sessions. See our webpage for more details.