USFS Testing Application : The Skating Club of Wilmington

Registrant Information

Test Date*

Hidden

Today*

Skater's Name*

First Last

USFSA Membership No.*

Registered Club*

Name of Club through which you are registered with US Figure Skating:

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

SCW Affiliation*

Indicate your affiliation with SCW.

Testers not registered with US Figure Skating through SCW must submit a permission-to-test letter from his/her Home Club. The letter may be mailed or scanned and sent via e-mail as a jpg or pdf file to dianask8r@me.com

Non-Member
Associate Member
Full Member - Basic, Bronze or Sapphire
Full Member - Silver & above

Testing Selections

Below please indicate the testing category(s) then select the desired tests that you are registering for.

Testing Categories*

Skating Skills, Singles, Pair Testing
Dance Testing

Skating Skills

Singles

Pair

Bronze $31 (1st candidate) $20 (2nd candidate)
Pre-Silver $43 (1st candidate) $26 (2nd candidate)
Silver $49 (1st candidate) $29 (2nd candidate)
Pre-Gold $59 (1st candidate) $34 (2nd candidate)
Gold $69 (1st candidate) $39 (2nd candidate)
Adult Pair Bronze $37 (1st candidate) $23 (2nd candidate)
Adult Pair Silver $43 (1st candidate) $26 (2nd candidate)
Adult Pair Gold $49 (1st candidate) $29 (2nd candidate)

Pair Partner's Name*

First Last

Pair Partner's Home Club*

Dance

Pattern Dance Testing Options

MUST choose one of the following

Lead Partner
Follow Partner

Dance Testing Option

Check the in the appropriate box(es) ONLY if you are testing under the Adult, Master or Solo Only basis for any of the dances listed above. If you have special instructions or requirements, go to the last box on this form.

Adult
Master
Solo Only

Free Dance

Bronze $22 (1st candidate) $16 (2nd candidate)
Pre-Silver $32 (1st candidate) $21 (2nd candidate)
Silver $42 (1st candidate) $26 (2nd candidate)
Pre-Gold $52 (1st candidate) $31 (2nd candidate)
Gold $62 (1st candidate) $36 (2nd candidate)
Adult or Master Pre-Bronze $22 (1st candidate) $16 (2nd candidate)
Adult or Master Bronze $32 (1st candidate) $21 (2nd candidate)
Adult or Master Silver $42 (1st candidate) $26 (2nd candidate)
Adult or Master Gold $52 (1st candidate) $31 (2nd candidate)6

Free Dance Testing Option

Check in the appropriate box(es) ONLY if you are testing Adult, Masters and/or Solo track. If you have special instructions or requirements, enter them into the last box (comments) on this form.

Adult
Master
Solo Only

ADDITIONAL FEES THAT MAY APPLY

If you meet any of the following parameters, please tabulate your additional fees. There is a $3 convenience fee already included in your online registration fee. All fees are subject to change.

Please review and tabulate additional fees (if any):

SCW Full Members - Silver and above & SCW Coaches Fee: $0
SCW Full Members - Basic, Bronze, and Sapphire Fee: $20
SCW Associate Members & Non-SCW Members Fee: $40

Additional Fee Skating Skills, Singles, Pair Testing

Enter appropriate amount according to the above extra fee schedule. Testing chair may adjust as necessary before submitting charge.

Additional Skating Skills, Singles & Pair Testing Fees Confirmation*

I have reviewed the required additional Skating Skills, Singles & Pair Testing fees.

Please confirm that you have reviewed and added any Skating Skills, Singles & Pair Testing additional fees that apply.

ADDITIONAL FEES THAT MAY APPLY

If you meet any of the following parameters, please tabulate your additional fees. There is a $3 convenience fee already included in your online registration fee. All fees are subject to change. Please review and tabulate your additional fees (if any):

Late application fee remains at $25
SCW Full Members -Silver & above & SCW Coaches Fee: $0
SCW Full Members - Basic, Bronze and Sapphire Fee for dances & above: $6/dance
Associate Members & All Other testers: $11/dance
Each Non-SCW Member Free Dance Candidate: $10/free dance

Additional Fee Compulsory Dance

Enter appropriate amount according to the above extra fee schedule. Testing chair may adjust as necessary before submitting charge.

Additional Compulsory Dance Fees Confirmation*

I have reviewed the required additional Compulsory Dance fees.

Please confirm that you have reviewed and added any additional Compulsory Dance fees that apply.

COACHING REQUIREMENTS

Coach's Name

First Last

Since this is an online process, you testify that your coach has approved this application and therefore his/her signature is hereby implied by submitting this test application.

Coach's USFSA Membership No.*

Coach's Email*

Coach's Phone*

Disclaimer*

You recognize that The Skating Club of Wilmington is not liable for injury during participation of any activity or theft of personal belongings.

Yes, I have read and agree to the above Disclaimer.

Online Application Processing Fee*

Online Application Fee ($3)

Late Application Fee (October)*

Late Application Fee ($25)

Late Application Fee (November)*

Late Application Fee ($25)

Late Application Fee (December)*

Late Application Fee ($25)

Late Application Fee (January)*

Late Application Fee ($25)

Late Application Fee (February)*

Late Application Fee ($25)

Late Application Fee (March)*

Late Application Fee ($25)

Late Application Fee (May)*

Late Application Fee ($25)

Late Application Fee (June)*

Late Application Fee ($25)

ORDER TOTAL

Total cost of testing registration to be charged: Please check your order before authorizing this amount to be charged on your credit card.

$0.00

Payment Information

Skaters may cancel tests, but fees are not refundable. To cancel, please write an e-mail to testing@skatewilm.com.

Cardholder's Name*

Cardholder's Email*

Card Number*

Card Type*

CCID*

Expiration Month*

Expiration Year*

Comment/Special Requests

Please explain any special requests pertaining to your order so that we may better accommodate you at the event.

IMPORTANT REMINDER

A letter of permission to test must be received if Home Club is other than The Skating Club of Wilmington. The letter may be mailed or scanned and sent via e-mail as a jpg or pdf file to testing@skatewilm.com.