1. Application for evaluation of student-skater.

1. Name:                                                                                  
2. Date of Birth:                                                                      
3. Address and phone:                                                              
4. Years of skating:                                                                   
5. Skating per week in hours:                                                  
6. USFSA                               ISI levels of freestyle                 
7. Moves in the field passed only USFSA                                  
8. 7. Jumps:     Axel    Salhov Toeloop  Loop  Flip  Lutz
9. Single                                                                     

1. Double                                                                     

1. Triple                                                                        

1. Did you take any ballet or gymnastic lessons?                       
2. Other athletic activities:                                                         
3. Name of previous skating coach (if any):                                                                                                          
4. What do you love about figure skating?                                 

1. What are parent’s expectations about their child’s skating ?

1. What skating program would you like to be part on competitive USFSA       or recreational ISI?

1. Would you like to compete?
2. If yes, in what competitions USFSA or ISI

1. What is important in competition for you, participation, victory, or friendship between athletes?

1. Other comments or suggestions:

 Email:go2sk8@sk8amir.com

Signature________________                       

Date____________________