Peninsula Skating Club
Dance Test Application
Applicant's Name _____________________________________ Phone_____________________________
Address ____________________________________________ City_________________
ZIP ____________
USFSA # __________________ Home Club _____________________
Test Date _______________________
Test Partner's Name __________________________________ USFSA # _____________________________
Applicant's Signature ____________________________________
Pro's Signature ______________________
Date of last test ________________________________________
School name and address ___________________________________________________________________
Principal's Name ________________________________ Test Fee Enclosed: $ ________________________
PLEASE CIRCLE THE TESTS YOU PLAN TO TAKE:
DANCE TESTS |
FREE DANCE TESTS | ||
| Preliminary Dance (complete) | $60 | Juvenile | $30 |
| Preliminary per dance | $30 | Intermediate | $35 |
| Pre-Bronze Dance (complete) | $60 | Novice | $40 |
| Pre-Bronze per dance | $30 | Junior | $45 |
| Bronze Dance (complete) | $60 | Senior | $50 |
| Bronze per dance | $30 | ||
| Pre-Silver Dance (complete) | $60 | ||
| Pre-Silver per dance | $30 | NON-PENINSULA HOME CLUB (per test session) | $25 |
| Silver Dance (complete) | $80 | ||
| Silver per dance | $35 | If you are taking individual dances, please indicate below which tests you are taking: | |
| Pre-Gold Dance (complete) | $100 | ||
| Pre-Gold per dance | $35 | ||
| Gold/International Dance (complete) | $100 | ||
| Gold/International per dance | $35 | ||
NOTE: ALL TESTS CANCELED BY THE SKATER LESS THAN TWO WEEKS
PRIOR TO THE TEST DATE WILL HAVE TO
BE RESCHEDULED. NEW APPLICATIONS AND FEES MUST BE SUBMITTED TO THE DANCE TEST
CHAIR.
APPLICATIONS MUST BE SUBMITTED BY MAIL TO THE DANCE TEST
CHAIR NO LATER THAN 3 WEEKS PRIOR TO THE
PREFERRED TEST DATE.
Please send applications to:
Xiao Lin
Dance Test Chair
3956 Lakeside Drive
San Jose, CA 95148
rev 09/19/07