| 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.
http://mit.edu/skatingclub/www/membership.html
|