U.S. Figure Skating Technical Panel Committee

Application to Test for Technical Panel Advancement

This form is for technical panel officials seeking permission to test for advancement in a discipline (singles/pairs/dance/ synchronized) and position (controller/specialist/data operator) in which the official already holds at least a nonqualifying appointment. Those seeking an initial certification should review the information on How to become a Technical Panel Official available on the Technical Controllers/Specialists page of U.S. Figure Skating Online.

Please print or type clearly. A separate application is required for each appointment.

Application for advancement as a: / SinglesPairsDanceSynchronizedSingles/Pairs/Dance / ControllerSpecialistData Operator / Date:

What level appointment do you currently hold for this position?

Candidate’s Personal Information

Name: / Membership #:
Address:
City: / State: / Zip:
Daytime Phone: / Evening Phone:
E-mail Address:

Candidate’s Present Status

Other technical panel appointment(s):
Date of most recent appointment:
Location and year of most recent Technical Panel Seminar:

Have you ever applied for this appointment before? No Yes – if yes, give date:

Appointment Qualifications (use additional paper, if necessary)

U.S. Figure Skating tests passed:
Moves in the Field: / NonePre-PreliminaryPreliminaryPre-JuvenileJuvenileIntermediateNoviceJuniorSeniorAdult Pre-BronzeAdult BronzeAdult SilverAdult Gold / Free Skate: / NonePre-PreliminaryPreliminaryPre-JuvenileJuvenileIntermediateNoviceJuniorSeniorAdult Pre-BronzeAdult BronzeAdult SilverAdult Gold
Pairs: / NonePreliminaryPre-JuvenileJuvenileIntermediateNoviceJuniorSeniorAdult BronzeAdult SilverAdult Gold / Compulsory Dance: / NonePreliminaryPre-BronzeBronzePre-SilverSilverPre-GoldGoldInternationl
Figures: / NoneFirstSecondThirdFourthFifthSixthSeventhEighth / Free Dance: / NoneJuvenileIntermediateNoviceJuniorSeniorAdult Pre-BronzeAdult BronzeAdult SilverAdult Gold
If you have test achievements from another ISU member, please describe:
Competition achievements (give years, levels and country of representation (if not USA)):
Current level of coaching (if applicable). Put “none” if not coaching.
Do you have any judging or referee appointments? No Yes
If yes, what types and levels?
Current skating activity:
Competitions served as Technical Panel Official at current level.
Attach any summary sheets and 104s for all events.
National Technical Panel Seminars(s) attended for this appointment – locations and dates
Attach certificates or request verification from headquarters.
Continuing Education Schools attended for this appointment – competition names, dates and faculty name(s)
Attach schedule(s) and faculty contact name.

References

Minimal level: Sectional Technical Specialist, Technical Controller or Data/Video.
References may not be members of the Technical Panel Committee in the candidate’s region.
GIVE FULL NAME, ADDRESS, EMAIL ADDRESS AND TECHNICAL PANEL LEVEL
The names and contact information for all technical panel officials and members of the Technical Panel Committee can be found in the U.S. Figure Skating Directory, which is available on the Members Only site (www.usfsaonline.org).
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A candidate applying for permission to test for advancement will be notified within 60 days of receipt of the application as to whether permission is granted. If permission is granted, the candidate must then apply to attend a National Technical Panel Seminar or Continuing Education School where testing is offered in the applicable discipline in order to test for advancement.

To be completed by U.S. Figure Skating Technical Panel Committee

Reviewed by Technical Panel Sectional Vice Chair

Signature: / Date:

Reviewed by Technical Panel Chair (for National Appointments)

Signature: / Date:
APPLICATION IS: / GRANTED / REJECTED / Date:

Submit completed applications to the appropriate Sectional Vice Chair (SVC) on the Technical Panel Committee. The names and contact information for all SVCs can be found in the U.S. Figure Skating Directory, which is available on the U.S. Figure Skating Members Only Site (www.usfsaonline.org).