Peninsula Skating Club
Moves - Freeskating - Pair Test Application


Applicant's Name: ______________________________   Phone: _______________________________
Address ______________________________ City _______________________  Zip _______________
E-mail address _________________________
USFSA # ____________________  Home Club: _______________________  Test Date: __________
Rink Requested: (check one)   San Jose _______       Belmont _____    Fremont ________

Applicant's Signature _____________________________________________________


Pro's Name          _____________________________  Signature  _____________________________

    PLEASE CIRCLE TEST TO BE TAKEN!

MOVES IN THE FIELD

FREE SKATING

PAIRS

Pre-preliminary $25 Pre-preliminary $25 Preliminary $25
Preliminary $30 Preliminary $25 Juvenile $35
Pre-juvenile $40 Pre-juvenile $35 Intermediate $40
Juvenile $40 Juvenile $35 Novice $45
Intermediate $45 Intermediate $40 Junior $50
Novice $50 Novice $45 Senior $55
Junior $50 Junior $50    
Senior $55 Senior $55    

ADULT FREE SKATING

Pre-Bronze $30 Bronze $35 Silver $40 Gold $45
ADULT MOVES IN THE FIELD
Pre-Bronze $30 Bronze $35 Silver $40 Gold $45

NON-HOME CLUB FEE: $25 PER SESSION

NOTE:  TESTS CANCELED BY THE SKATER LESS THAN 2 WEEKS PRIOR TO THE TEST DATE WILL REQUIRE A NEW APPLICATION AND A NEW CHECK IN ORDER TO BE RESCHEDULED.

Applications must be received by the Test Chairman no later than 3 weeks prior to the test date.

Mail applications for San Jose tests  to:    Deirdre Fujimoto
                                                                         60 Sugar Hill Drive
                                                                         Hillsborough, CA 94010

Mail applications for Fremont tests to:  Patt Martin
                                                                      1814 Kern Loop
                                                                      Fremont, CA 94539

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