Florida GoldCoast Figure Skating Club

Test Application

NAME______________________________________________USFSA#________________________

ADDRESS____________________________CITY________________STATE_____ZIP___________

PHONE#(____)_________________________HOME CLUB______________________________

NAME OF DANCE/PAIR PARTNER_____________________________USFSA#________________

PARENT NAME_____________________________________________________________________

PLEASE CHECK OFF TEST REQUESTED

* The Moves in the Field Test must be passed before taking the corresponding Freestyle test.

** Please indicate if the Dance test will be taken Standard, Adult(over 25yr), or Masters( over 50yr).

ALL FEES ARE NON-REFUNDABLE UNLESS TEST IS CANCELLED BY FGCFSC.

MOVES*	FREESTYLE	DANCE** CIRCLE DANCE	PAIR(PER CANDIDATE)
Pre-Prelim- $50	Pre-Prelim-$35	Prelim-DW,CT,RB- $25each	Preliminary- $25
Prelim- $55	Prelim- $40	Pre-Brz-SD,CC,FIT-$25each	Juvenile-$30
Pre-Juv- $60	Pre-Juv- $45	Bronze-HH,WW,TF-$30each	Intermediate- $35
Juvenile- $65	Juvenile- $55	PreSilv-14S,EW,FT-$30each	Novice- $40
Intermediate-$70	Intermediate- $60	Silver-AW,T,RF-$35each	Junior- $45
Novice- $75	Novice- $65	PreGold-BL,K,PD- $35each	Senior- $TBA
Junior- $80	Junior-$70	Gold-VW,WW,QS,AT- $TBAeach
Senior- $TBA	Senior- $TBA	Internat-SW,R,YP,RW,TR-$TBA
Adult Pre-Bronze- $55	Adult Pre-Bronze-$40
Adult Bronze- $60	Adult Bronze- $50
Adult Silver- $65	Adult Silver- $55
Adult Gold- $70	Adult Gold- $60

Signature of Professional_______________________________Phone#_______________________

***************NON HOME CLUB TESTERS ADD $20 GUEST FEE TO TOTAL*************

NON FLORIDA GOLDCOAST FSC MEMBERS MUST COMPLETE AND HAVE SIGNED

A PERMISSION TO TEST FORM BY THEIR HOME CLUB TEST CHAIR.

NO TEST WILL BE SCHEDULED WITHOUT THIS FORM. (TR.3.08)

ALL FEES MUST BE RECEIVED 10 DAYS BEFORE THE TEST DATE. FEES MAY BE PAID BY

CASH, MONEY ORDER OR CASHIERS CHECK. ALL APPLICATIONS MUST BE SIGNED BY

YOUR PROFESSIONAL

PLEASE MAKE CHECKS PAYABLE TO: FLORIDA GOLDCOAST FSC.

MAIL APPLICATION, PERMISSION FORM, AND FULL PAYMENT TO:

DEBI SHAPIRO (Test Chair)

4336 HUNTING TRAIL

LAKE WORTH, FL 33467

561-433-1105

Florida GoldCoast FSC members only:

Please add optional $10.00 judges hospitality fee to total in lieu of bringing a dish to the test session.

8/03 – copied from floridaskating.com