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               US Figure Skating Test Application

Application Deadline:

One week prior to test

 

 

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Candidate’s Name                                                          USFSA Number                     Email address                                                 Date of Birth

 

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Address                                                                                                                 City                                              State                     Zip

 

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Telephone Number                                                       Last test passed/date                                                                     Last test failed/date

 

 

I certify that the skater listed above is a member in good standing of the _______________________________________________________________

For the membership year 2007/8 and has the Club’s permission to test.

 

_____________________________________________                             _____________________________________

Signature of Skater’s Club Representative                                                                             Professional’s Signature

 

_____________________________________________                              ____________________________________

Signature of Skater                                                                                                                                Signature of Parent/Guardian if under 18

 

Field Moves     (circle test/s)                           Freestyle                   (circle test/s)

Test                       Fee                                                   Test                      Fee

Pre-Preliminary              $30.00                                                  Pre Preliminary              $30.00

Preliminary                    $30.00                                                  Preliminary                    $30.00

Pre-Juvenile                   $35.00                                                  Pre Juvenile                   $35.00

Juvenile                         $40.00                                                  Juvenile                         $40.00

Intermediate                  $45.00                                                  Intermediate                  $45.00 

Novice                           $50.00                                                  Novice                           $50.00

Junior                            $55.00                                                  Junior                            $55.00

Senior                           $60.00                                                  Senior                           $60.00

Adult Pre-Bronze            $30.00                                                  Adult Pre-Bronze            $30.00

Adult Bronze                  $30.00                                                  Adult Bronze                  $30.00

Adult Silver                    $35.00                                                  Adult Silver                    $35.00

Adult Gold                      $40.00                                                  Adult Gold                      $40.00

                                    

 

                         _____$15.00 Hospitality Fee (ALL SKATERS)

 

______$25.00 Non SCN Member Fee

 

______$10.00 Practice Session (8am-8:50am)

 

 

Skaters must be present 1 hour prior to his/her test time ◊ Make checks payable to Skating Club of Natick

 NO REFUNDS ◊ $25.00 fee is applicable for returned checks    

All test sessions are held at the William L. Chase Arena ◊ 35 Windsor Avenue, Natick

Donna Rozon, Test Chair ¨ phone 508-655-1013 ¨ fax 508-651-0118