European Taekwondo Qualification Tournament for London 2012 Olympic Games

European Taekwondo Qualification Tournament for London 2012 Olympic Games

(Kazan, Russia/ January 27-29, 2012)

-Entry deadline: January 7, 2012 -

APPLICATION FORM

We hereby submit the application to participate in European Qualification Tournament for 2012 London Olympic Games.

Name of Association
Address
Telephone No
Fax No
E-mail
Contact Person
Position / No. of Persons / Remarks
Officials / Male team
Female team
Contestants / Male team
Female team
Others
Total
Name of President: / Signature of President

Note: the following documents must be submitted to together with this form.

-Scanned passport copy (official and athlete)

-Scanned Kukkiwoin Dan certificate (athlete)

-Passport-sized photo in electronic format (official and athlete)

LIST OF TEAM MEMBERS

OFFICIALS

Position / Last Name / First Name / Date of birth
(dd-mm-yy)
Head of Team
Manager / Male
Female
Male Coach / Male
Male
Female Coach / Female
Female
Trainer / Male
Female
Team Doctor / Male
Female

CONTESTANTS

Weight / Last Name / First Name / Date of birth (dd-mm-yy) / Global Athlete License (GAL) / Kukkiwon Dan No.
Male -58kg
Male -68kg
Male -80kg
Male +80kg
Female -49kg
Female -57kg
Female -67kg
Female +67kg

Athletes’ GAL Number: If available / not mandatory

Name of President: / Signature of President

INDIVIDUAL ENTRY FORM FOR OFFICIALS

TO: WTF only
World Taekwondo Federation
4th Fl, Joyang B/D, 113 Samseong-dong,
Gangnam-gu, Seoul, Korea 135-090
Tel: (82.2) 566 2505 / 557 5446
Fax: (82.2) 553 4728
E-mail: / * No Copy to Organizing Committee
Position (please tick) / ☐Head of Team ☐ Manager ☐ Coach
☐ Trainer ☐ Team Doctor ☐ Others
Name of Association
Division (please tick) / ☐ Male☐ Female
Family Name
(as in Passport) / Given Name
(as in Passport)
Passport No. / Nationality
Date of Birth / Dan Certificate
No. (If any)
dd - mm - yyyy
Height / cm / Weight / kg
Residential Mailing
Address
Home Tel No. / Mobile Phone No.
Fax No. / E-mail Address
Name of Contact
Person in MNA
Tel No. / Mobile Phone No.
Fax No. / E-mail Address

Note: Please make enough copies to fill out the information of all participating officials and send copies of the completed forms to ,

INDIVIDUAL ENTRY FORM FOR ATHLETES

TO: WTF only
World Taekwondo Federation
4th Fl, Joyang B/D, 113 Samseong-dong,
Gangnam-gu, Seoul, Korea 135-090
Tel: (82.2) 566 2505 / 557 5446
Fax: (82.2) 553 4728
E-mail: / * No Copy to Organizing Committee
Category & Status / Weight Division / ☐ M -58☐M -68☐ M -80 ☐ M +80
☐ W -49☐W -57☐ W -67 ☐ W +67
Division / ☐ Male☐Female / Name of Association
Family Name
(as shown in Passport) / Given Name
(as shown in Passport)
Passport No. / Nationality
Date of Birth / Dan Certificate
No. (a must)
dd - mm - yyyy
Height / cm / Weight / kg
Residential Mailing
Address
Home Tel No. / Mobile Phone No.
Fax No. / E-mail Address
Primary Training Facility Name:
Primary Training Facility Address:
Tel No. / Mobile Phone No.
Fax No. / E-mail Address

Note: Please make enough copies to fill out the information of all participating athletes and send copies of the completed forms to (WTF Sports Division)