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Central Fencing - Development Nomination Form for 2018
I want to join Central Fencing l Development Program for Under 15, Cadet and Junior fencers. I understand the program will focus on foil and epee at least in its start up phase.
Email address *
Full name (as listed in passport) *
Your answer
Date of birth *
MM
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DD
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YYYY
Physical address *
xx Street, Suburb, City, Postcode
Your answer
Postal address
if different from above
Your answer
CONTACT DETAILS
Home phone *
Your answer
Mobile phone *
Your answer
Email address *
Your answer
PASSPORT
Nationality *
Please list all if you have more than one
Your answer
Passport number *
Your answer
Passport expiry date *
MM
/
DD
/
YYYY
YOUR FENCING BACKGROUND
Year started fencing *
Your answer
Weapons fenced *
Required
Are you affiliated? *
Your club *
full name please, no abbreviations
Your answer
Club coach *
Your answer
Club coach email address *
Your answer
Does your coach support your application to join the programme? *
Do your parents/caregiver support your application *
Your parents'/ caregiver's name *
Your answer
Your parents'/ caregiver's email *
Your answer
EMERGENCY CONTACTS
Name *
Your answer
Relationship to you? *
Your answer
Emergency phone number *
Your answer
Emergency mobile number *
Your answer
Email address *
Your answer
MEDICAL INFORMATION
Who is your medical provider / GP? *
Name and phone number please
Your answer
Do you have any health conditions or disabilities relevant that affect your fencing or we need to be aware of if you are participating in training camps or international tours *
If you answered "yes", please describe your condition *
Your answer
Do you take any medications? *
If you take medications, please list them here
Your answer
FENCING RESULTS and YOUR GOALS
My top 5 competition results (last 12 months): *
Your answer
I have competed at national age group level *
I have a top 50% ranking on the FeNZ ranking system in my age group *
What is your top ranking on the FENZ ranking system by weapon *
Your answer
What do you intend to achieve in the next 12 months in fencing *
200 word limit please
Your answer
What are your longer term fencing goals? *
200 word limit please
Your answer
What motivates you to fence? *
200 word limit please
Your answer
Tell us about a time when you were highly motivated and successful? *
200 word limit please
Your answer
Tell us about a time when you were not successful, and how you dealt with this situation. Then; how your future actions were changed? *
200 word limit please
Your answer
Other than training and being coached, what other things do you do to assist your fencing? *
200 word limit please
Your answer
CONTRACTUAL UNDERSTANDING
I have read the nominee information letter *
I am committed to implementing an individual training plan that reflects the guidelines laid out in the information letter.I understand I will be expected to attend a number of regional, national and international events as agreed with my club coach and parents. I have attended, or propose attending, the following competitions and camps in the period to 30 Jan 2018 to support the achievement of my fencing goals: *
Your answer
I propose attending the following additional competitions in 2017 (not included in the above list): *
Please give information below
Your answer
A copy of your responses will be emailed to the address you provided.
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