JudoScotland TDP Application Form 2016/17

This form is for players who wish to be considered for membership of the JudoScotland Talent Development Programme, and the JudoScotland Talent Development Performance Programme. The information required on this form will provide valuable background information for the Selection Panel when considering athletes inclusion.

Applications must be in by the 31st December 2017

Selection will be communicated by the 16th January 2017

CANDIDATE DETAILS

Full Name: *

Email Address *

Date of Birth *

Contact / Mobile No: *

Home Tel No:

JudoScotland Licence No: *

Home Address: *

Judo Club Name: *

Judo Club Coach *

Judo Club Coach Telephone No: *

Judo Coach Email Address *

If you wish to be considered for the Talent Development Performance Programme you MUST fill in your Passport details.

Passport No:

Passport Valid From Date:

Passport Expiry Date:

PARENT / GUARDIAN EMERGENCY CONTACT DETAILS

Name: *

Emergency Number / Mobile Number: *

Home Tel No:

Work Tel No:

Email Address

Home Address: *

ACHIEVEMENTS

Please list your major competition results from the past two years below:

Date of Event

Competition Name:

Weight

Placing

Remarks (if any)

Date of Event

Competition Name:

Weight

Placing

Remarks (if any)

Date of Event

Competition Name:

Weight

Placing

Remarks (if any)

Date of Event

Competition Name:

Weight

Placing

Remarks (if any)

Date of Event

Competition Name:

Weight

Placing

Remarks (if any)

Date of Event

Competition Name:

Weight

Placing

Remarks (if any)

Further achievements (if more space required):

GOALS AND AMBITIONS

Please List Your Major Goals For The Next Four Seasons:

2017

2018

2019

2020

Please give a brief explanation of why you want to be part of the JudoScotland Performance Programme, what you expect from the programme and what you expect to give the programme:

Kit Sizes

Please can you indicate the size of kit you take. The sizing is comparable to Adidas kit, if you need to get an idea of your size please try on in a shop and take a note of what you would need. We would only be supplying this kit in adult sizing with XS being the smallest.

STATEMENT BY APPLICANT

I understand that the information I have provided is correct to the best of my knowledge and will be used only as part of the process of assessing my eligibility for selection to the JudoScotland Talent Development Programme.

Name of Applicant: *

Name of Parent or Guardian (if under 18):

By ticking this box, I agree to the above statement

Tick here

Guardian Approval (if applicable) By ticking this box, I agree to the above statement

Tick here

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