St. Moritz Isc Ijs Protocol Submission Form

ST. MORITZ ISC –IJS PROTOCOL SUBMISSION FORM

Singles Free Skate, Pairs Free Skate, Partnered Free Dance

Please fill out all information completely

NOTES:

• Only home club members may submit their IJS Protocol for test credit to the St. Moritz ISC Test Chair.
• The required paperwork must be obtained during the competition in which you earned the appropriate test credit. The Accountants will not provide a ‘test credit packet’ after the conclusion of a competition.
• The host club for a competition may charge a fee for a ‘test credit packet.’ This is in addition to the fee noted below for processing the protocol for test credit.
• The IJS protocol for test credit will be processed as soon as possible after it has been received.
• This application must be submitted no later than August 30thfor those who need the test processed before the qualifying competition deadline.

TEST PROCESSING FEE: $20.00 (all levels) Fee must be included with this form.

Skater’s Name
U.S. Figure Skating Member #
Parent’s Name (if under 18)
E-Mail Contact
Phone Number
Coach’s Name
Coach’s E-Mail Contact
Coach’s Phone Number
I verify that the athlete listed above is eligible to receive Test Credit through IJS protocol. I have seen the unaltered and correct scores, which match the protocol the athlete is submitting. I understand that altering a protocol sheet to meet the test requirement is considered an ethics violation of U.S. Figure Skating and the Professional Skaters Association.
Coach’s Signature

Select the test you are requesting credit for:

SINGLES FS TESTS / PAIRS FS TESTS / FREE DANCE TESTS
Juvenile / Juvenile / Juvenile
Intermediate / Intermediate / Intermediate
Novice / Novice / Novice
Junior / Junior / Junior
Senior / Senior / Senior
Adult Gold

Instructions:

1. Home Club members will submit this application to the Test Chair.
2. Skater must attached the following to the form:

• The overall event results, which include the names and signatures of the Event Referee and Technical Controller.
• Your individual protocol.
• Your Test Credit Skater report from the competition

1. The application must be filled out completely and the fee enclosed or it will be returned to the skater. Mail the completed form with a check or money order payable to “St. Moritz ISC” to:

Lisa Erle, 11753 Silvergate Dr., Dublin, CA 94568

Contact: Email: ev. 11/1/17