Test Form

North Hills Figure Skating Club

(prices will be changing on 1-1-2001)

Test Application

Candidate				USFSA #
Address
City	State	Zip Code		Phone #
Home Club			Test Date Requested

(If other than NHFSC, a letter of permission must accompany application)

Freeskating			Moves in the Field
	Pre-Preliminary	$20.00		Pre-Preliminary	$20.00
	Preliminary	$20.00		Preliminary	$20.00
	Pre-Juvenile	$20.00		Pre-Juvenile	$20.00
	Juvenile	$20.00		Juvenile	$20.00
	Intermediate	$25.00		Intermediate	$25.00
	Novice	$30.00		Novice	$30.00
	Junior	$35.00		Junior	$35.00
	Senior	$40.00		Senior	$40.00
Pairs
	Pre-Preliminary	$25.00		Intermediate	$25.00
	Preliminary	$25.00		Novice	$30.00
	Pre-Juvenile	$25.00		Junior	$35.00
	Juvenile	$25.00		Senior	$40.00
Adult Tests
Figures			Free Skating
	Pre-Bronze	$30.00		Pre-Bronze	$15.00
	Bronze	$35.00		Bronze	$20.00
	Silver	$40.00		Silver	$25.00
	Gold	$50.00		Gold	$30.00

Second Club Members: Add $1.00 to the above fee

Non-Members: Add $25.00 to the above fee

Total Fees:
Second Club Member Fee ($10.00):
Non-Member Fee ($25.00):
Total Due:

Direct any test request forms, test fees and any inquires to:

Nanci Flores

17681 Bryan Place

Granada Hills, CA 91344

Appropriate test fees must accompany test request and be received by the test chair no later than three (3) weeks prior to the date of test. This does not guarantee the session of your choice. Priority in scheduling is done on a first come first serve basis, determined by postmark on the candidate's envelope. TEST FEES ARE NON-REFUNDABLE unless cancellation or rescheduling is due to an injury. A doctor's letter must accompany refund requests. A request to move a test to a later date will be considereed a cancellation and a new test forma and fees must be submitted.

PLEASE DO NOT LEAVE APPLICATIONS IN ICEOPLEX OFFICE.

PLEASE MAKE CHECK PAYABLE TO: "NORTH HILLS FIGURE SKATING CLUB"

Hospitality for the test will be provided by the test candidate. You will be contracted by the Test Chairperson.


(Candidate or Parent/Guardian signature if under 18)		Date

Professional's Signature		Date

The USFSA has instituted a Recognition of Test Achievement Program for the following levels: (a) Figures - Fourth through eight level; (b) Free Skating and Moves - Novice through Senior. If you wish to participate in this program , a letter of recognition will be sent directly to the principle of y our school. The letter will be accompanied with a request that it be placed in your permanent record. If you wish to participate please fill out the following information:

Name of School
Name of Principal
School Address

NHFSC CLUB USE ONLY:

Date Received: _________________

Paid by: ? Cash ? Check # ______ Amount $_______ Date to Treasurer: __________

Verbal approval to test received from:_______________________ Date:__________

PLEASE MAKE CHECK PAYABLE TO: "NORTH HILLS FIGURE SKATING CLUB"

For problems or questions regarding this web contact Catherine Litten

background and clip art can be found at Lisa's Clip Art Galore

Last updated: December 05, 2000.