Thank You for Downloading the Nomination Pack for the 2010 World Universitychampionships

Thank you for downloading the nomination pack for the 2010 World UniversityChampionships. Enclosed within this pack you will find all of the required documents for your nomination for selection for the 2010Championships.

Please ensure that you read all of the information carefully and complete ALL of the required paperwork CORRECTLY. If you have any queries about the paperwork please contact the BUCS office on 020 7633 5080.

We have included a check list to help you to ensure that you return all of the relevant documents to the BUCS office. If paperwork is returned to the Office incomplete you will be informed by email what information is missing and asked to complete it as soon as possible. If all of your paperwork has been completed correctly you will receive an email from us confirming receipt of the information.

PLEASE NOTE YOU WILL NOT BE CONSIDERED FOR SELECTION UNTIL ALL OF THE REQUIRED PAPERWORK HAS BEEN CORRECTLY COMPLETED AND RETURNED TO THE BUCS OFFICE.

The majority of future correspondence with you will be via email, therefore please ensure that you give us your correct email address being careful about whether it is a .com or .co.uk address

Further details pertaining to the Championships can be found at you should check this website for regular updates and further specific information for the travelling delegation.

Completed nomination packs should be returned to:

Claire Powell

BUCS

20-24 King’s Bench Street

London

SE1 0QX

Jo Kirk

Head of Development and International Programmes

Please complete and return ALL of the paperwork listed belowand tick the relevant boxes to confirm that the paperwork is included within the envelope.

Nomination Form
Please note this MUST be signed by AU President / Sport Officer /
Copy of back page of passport /
Certificate of Academic Eligibility / Graduation Certificate
CURRENT STUDENTS - Section 2 needs to be completed by a senior member of the university’s Registry Office or equivalent and NOT a member of the Athletic Union / Students Union or Sports Department. The institution stamp that is required should be the full and formal university stamp and not a students’ union / athletic union stamp. The university must also sign the reverse of the form to confirm that you meet the eligibility criteria. WE CANNOT ACCEPT FAXED OR EMAILED COPIES OF THIS FORM, IT MUST BE THE ORIGINAL
ONE YEAR DOWN STUDENTS
If you are a ‘One Year Down’ student (i.e. you graduated in 2009) please send a colour photocopy of your Graduation Certificate to the BUCS Office. You do not need to complete a Certificate of Academic Eligibility. /
Passport Photos x4
Please write your name on the back of ALLphotos (these must have a white background), alternatively jpeg photos maybe emailed to please indicate if they have been posted or emailed
Please circle Posted Emailed /
Medical Form
Please include a copy your TUE if applicable /
TUE (if applicable) /
Physiotherapy Form /
Press Form /

I confirm that I have sent all of the above paperwork to the BUCS Office, 20 – 24 King’s Bench Street, London, SE1 0QX.

Upon selection I acknowledge that I will be required to pay a personal contribution and sign a Team Members Agreement

Name / Signature
Date
OFFICE USE ONLY / Date Received / Checked / Input onto Database / Requested additional information

COMPETITOR NOMINATION FORM

Event / Sport:WORLD UNIVERSITYCHAMPIONSHIPS 2010– SAVATE

All fields are mandatory, complete in block capital letters and enclose a copy of the back page of your passport

PERSONAL DETAILS

Name as per passport:
Postal Address:
Post Code:
Email:
Mobile Number:
Home / Work Number:

PASSPORT DETAILS

Passport Number:
Expiry Date *
Date of Birth
Place of Birth

*you must have at least 6 months remaining on your passport to be able to travel

UNIVERSITY DETAILS

University:
Course:
Start Date:
Finish Date:

KIT SIZES

Leisurewear kit,where provided, will be supplied by Nike (unisex sizes)

XS (34/36) / L (41/43)
S (36/38) / XL (44/46)
M (38/40) / Height

DIETARY REQUIREMENTS

Vegetarian / Other (specify)
Signature:
Date:

ELIGIBILITY REQUIREMENTS

BUCS currently applies the following regulations when selecting representative teams to participate in FISU competitions:

a)FISU Regulations 5.2.1

Only the following may participate as competitors in a FISU Sporting Event:

i)Students who are currently officially registered as proceeding towards a degree or diploma at the university or similar institute whose status is recognised by the appropriate national academic authority of their country (e.g. the Department of Education in the UK).BUCS has adopted a minimum level of qualification for eligibility for FISU events. This is set at level 4 of the Framework for Higher Education Qualifications in England Wales and Northern Ireland or equivalent.

ii)Former students of the institutions mentioned in (i) who have obtained their academic degree/diploma in the year preceding the event. i.e. students graduating in 2009 are eligible to compete.

b)FISU Regulations 5.2.3

All competitors must satisfy the following conditions.

i)be a national of the country they represent (therefore hold a full 10 year UK passport)

ii)be at least 17 and less than 28 years of age on January 1st in the year of the event (born between 1 January 1982 and 31 December 1992)

c)Students studying abroad are eligible for selection provided they satisfy FISU regulations 5.2.1 and 5.2.3

d)Students attending courses franchised out from an institution [complying with FISU Regulations 5.2.1 (i)] are eligible for selection providing they also satisfy FISU Regulation 5.2.3.

WARNING

The information given overleaf must be accurate and to the best of the signatories’ knowledge at the date indicated below. Action will be taken against anyone falsifying information or wilfully misleading BUCS. Should any information change, please inform the Head of Development & International Programme immediately. Please ensure that you have read and understood the Eligibility Requirements.

We certify that the above information is correct and have read the regulations regarding eligibility.

Signed:Signed:

(Athlete)(AU President / Sports Officer)

Name (print):Name (print):

Date: Date:

Certificate of Academic Eligibility

Event / Sport:WORLD UNIVERSITY CHAMPIONSHIPS 2010– SAVATE

1. To be completed by competitor (in block capital letters)

Name as per Passport
UK Passport Number & Name of Issuing Office:
Place of Birth: / Date of Birth:
Institution: / Name & Title Degree:
Humanities / Science / Physical Education / Other Studies (delete as appropriate):
Course Commenced (date): / Course Ends (date):

2. To be completed by Institution Official(please turn over and sign the eligibility regulations)

I certify to the best of my knowledge that the above Academic Record is correct

Signed: / Print Name:
Position in Institution: / Date:

Photograph of CompetitorOfficial Institution Stamp

(This must be the official stamp of the institution, not the Student / Athletic Union stamp)

ELIGIBILITY REQUIREMENTS

BUCS currently applies the following regulations when selecting representative teams to participate in FISU competitions:

a)FISU Regulations 5.2.1

Only the following may participate as competitors in a FISU Sporting Event:

i)Students who are currently officially registered as proceeding towards a degree or diploma at the university or similar institute whose status is recognised by the appropriate national academic authority of their country (e.g. the Department of Education in the UK). BUCS has adopted a minimum level of qualification for eligibility for FISU events. This is set at level 4 of the Framework for Higher Education Qualifications in England Wales and Northern Ireland or equivalent.

ii)Former students of the institutions mentioned in (i) who have obtained their academic degree/diploma in the year preceding the event. i.e. students graduating in 2009 are eligible to compete.

b)FISU Regulations 5.2.3

All competitors must satisfy the following conditions.

i)be a national of the country they represent (therefore hold a full 10 year UK passport)

ii)be at least 17 and less than 28 years of age on January 1st in the year of the event (born between 1 January 1982 and 31 December 1992)

c)Students studying abroad are eligible for selection provided they satisfy FISU regulations 5.2.1 and 5.2.3

d)Students attending courses franchised out from an institution [complying with FISU Regulations 5.2.1 (i)] are eligible for selection providing they also satisfy FISU Regulation 5.2.3.

WARNING

We certify that the above information is correct and have read the regulations regarding eligibility.

Signed:Signed:

(Athlete)(AU President / Sports Officer)

Name (print):Name (print):

Date: Date:

World University Championships2010

Confidential Medical Questionnaire

PLEASE COMPLETE CLEARLY IN BLOCK CAPITAL LETTERS

SPORT
Name
Date of Birth
Address
E-mail
Contact Tel Number
GP / Doctors Name, Address & Telephone number. Hospital Number if under hospital care.
Two Next of Kin Contact Details: Address and Telephone Number
1. Name:
Address:
Tel: / 2. Name
Address:
Tel:

Please list ALL regular or one off medication and any supplements taken over the last 3 months.

Inc. Name, dose, route of admin, reason for taking, last taken, tested?
Are you taking any medication banned or subject to restrictions in your sport?
Inc. Name, dose, route of admin, reason for taking, last taken, tested?, Do you have a current TUE?
Are you an asthmatic on regular or occasional treatment?
If yes, what is your treatment?

Have you had an injection in the past 6 months?

If yes, please list the name of drug, dose given, date given and frequency.
Current TUE(Therapeutic Use Exemption)certificates:
Substance / Dose / Method of administration / Date submitted / Expiry Date / Granted by
Eg salbutamol / 100mcg / Inhalation 2puffs as nec / 10/6/07 / 31.5.09 / UKSport

FAILURE TO DECLARE A BANNED SUBSTANCE EVEN IF TAKEN AS CORRECT TREATMENT CAN RESULT IN A POSITIVE DOPING TEST

Please enclose a copy of current TUE if applicable

Please use this space to provide any additional information that you feel is relevant.

Further advice

Before you travel to any destination make sure you have all the recommended vaccinations. Information can be found on:

Always check in with your GP/travel nurse at least 4 weeks before travel.

Make sure you take enough medications with you for the duration of the trip.

If you have any doubt regarding the water in the country you are going to, drink bottled water only.

Make sure you are diligent with hand washing at all times.

Declaration

I hereby confirm that the information above is accurate and complete. I confirm that I am not taking any banned substances and I will not take any medication or supplements during the championships without first consulting a member of the medical team. All information contained herein is confidential and will only be available to the medical team. I also agree in the case of emergency that information can be obtained from my doctor at home.

SignatureDate

Please complete and send to:

Claire Powell, BUCS, 20 – 24 King’s Bench Street, London, SE1 0QX

If, after completing this form, you become ill or injured, please update your team manager and the Jo Kirk Head of Development and International Programmes, at or via the BUCS Office 0207 633 5080

World University Championships2010

Confidential Physiotherapy Questionnaire

PLEASE COMPLETE CLEARLY IN BLOCK CAPITAL LETTERS

SPORT
EVENT
Name:
Address:
Telephone number - / Daytime: / Evening:
E-mail address
Date of birth:
Event:
YES / NO
Have you suffered from any injuries during the past six months?
If yes, did you attend a physiotherapist, doctor or hospital for treatment?
Please give a written description of the injury (including the location and type of injury) and any treatment received
YES / NO
Are you still under the care of a physiotherapist, doctor or hospital?
If yes, what treatment are you currently receiving?
Please describe your current symptoms.
YES / NO
Do your current symptoms restrict your sporting activity?
Do you have any other ongoing injuries that you have not already mentioned?
If yes can you describe them, including how long they have been present and the treatment you are receiving?
If you are currently attending for physiotherapy treatment, please ask your physiotherapist to provide a brief report of your condition and treatment and return it with this form. Please provide their contact details below:
Name
Email Address
Tel No

Signed:Date:

World UniversityChampionships2010

Press Form

Please complete in block capital letters

Name
Sport
University
Course
Year of Study
Club/s

1.Please list details of your past records/performances – including event, result, competition, location and time/distance (where applicable):

2.List any awards/honours you have received:

3.How long have you been participating in your sport?

4.Why did you start participating in this sport?

5.Who has been the most influential person in your sporting career and why?

6.Have you had any major injuries, and for how long did they prevent you from participating in your sport?

7.Have you ever played another sport at an elite level, apart from the one you practice now? If yes, please indicate which sports, and list any major honours achieved in that other sport.

8.Please list some points of interest about yourself (e.g. most memorable achievement, most amusing episode etc):

9.Who is your biggest rival?

10.List your hobbies and/or special skills:

11.List any sponsors/supporters:

Identify any relative who has competed in any sport at an elite level

Their name / Sport
Relationship to you / Event
Year of Participation / Result
13. Are you happy for journalists to contact you directly for additional information? YES / NO

Please note that contact details are kept confidential by BUCS and will only be released if a specific press request is made. BUCS will use the information collected here for promotions surrounding the World University Championships/ Games and for future BUCS events.

I confirm that the above information is correct:

Print Name:
Signed: / Date: