USFCA Coaching Clinic Proposal Form
Email address *
Clinic Information:
USFCA Region: *
USA Fencing Division: *
Clinic Name: *
Clinic Date *
MM
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Weapons *
Required
Clinic Location: *
Address: *
Phone: *
Email: *
Clinic cost USFCA member: *
Clinic cost USFCA non-member: *
Host (Organizer) Information:
Name of Fencing Organization: *
Host name: *
Address *
Phone: *
Email: *
Instructor Coach (USFCA Master or Prevot) Information:
Name: *
Address: *
Phone: *
Email: *
2nd Instructor Coach (USFCA Master or Prevot) Information:
Name: *
Address: *
Phone:
Email:
Non USFCA Presenter Information
Name:
Address:
Phone:
Email:
Bio:
Video your clinic
The USFCA is building a library of coaching videos. These videos are posted on the USFCA website and are available to all members. If you would like to contribute to the video body of knowledge for fencing coaching we encourage you to record some or all of the presentations of your clinic. Send your video to Enrique Alvarez Vasquez (enrique_azvz@yahoo.es)
Will video recording of presentations be a part of your clinic? *
Schedule of Events:
It is required to attach a proposed schedule of events to the application or fill in the area below. The clinic will only be sanctioned with an acceptable and complete schedule of events.

Curriculum outline of the daily schedule must include specific activities for the various sessions and weapons. Each instructors’ responsibilities must be briefly outlined.
Will certification testing be a part of the clinic?
Clear selection
The USFCA Certification and Accreditation Committee (CAB) must certify examiners. See ‘Certification’ section of the USFCA Website for forms and procedures for testing. Please note on the form if you are listed on the USFCA website as a Certified examiner or a Head Examiner (able to run the exam).
Examiner #1
Name:
Address:
Phone:
Email:
Examiner certifications:
Examiner #2:
Name:
Address:
Phone:
Email:
Examiner certifications:
Examiner #3:
Name:
Address:
Phone:
Email:
Examiner certifications:
Organizing Staff & Areas of Responsibilities:
Clinic Services:
• Accommodation: please attach a list of nearby hotels and negotiated rates if applicable.
• Ground Transportation:
• On-site Food Services:
Other activities (such as armory clinic, parents hour, etc):
Other information you wish to share:
“By signing this application, I certify that if this clinic is approved by the USFCA, I will return the Organizer’s Evaluation Form and Participant Evaluation Forms for every attendee to the address below within two weeks of the date of the clinic. I also certify that all paperwork associated with testing for certifications will be sent to the address specified in the CAB testing materials as soon as possible as indicated in the CAB materials for testing. Further, I will be held responsible for sending all proceeds due to the USFCA for all USFCA merchandise sold, returning unsold merchandise, and any other items provided by the USFCA to the USFCA.
Contact Name:
E-Signature (Initials):
Date:
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A copy of your responses will be emailed to the address you provided.
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