Please note that this form is not suitable for mobile phones. Please use a tablet or PC to complete.

If you are applying as a pair then please complete the form below.


Please read the Rules and Criteria before applying for the Competition:


Click here for the Rules of the Competition.

Click here for the NISA Criteria required.



Rink / Club


Competition Number/ Event /Level (required):

MALE SKATER DETAILS
FEMALE SKATER DETAILS
Competitor Name (required):
Competitor Name (required):
Date Of Birth (required):
Date Of Birth (required):
Address (required):
Address (required):
Telephone Number Mobile (required):
Telephone Number Mobile (required):
Telephone Number Home:
Telephone Number Home:
Your Email (required):
Your Email (required):
Age On Closing Date (1st June 2019)(required):
Age On Closing Date (1st June 2019)(required):
Age As At 1st July 2018 (required):
Age As At 1st July 2018 (required):
NISA Membership Number (required):
NISA Membership Number (required):
Date Skate UK Passport sent / NISA Membership Applied for :
Date Skate UK Passport sent / NISA Membership Applied for :


Highest NISA Tests Passed for both entrants

MALE SKATER DETAILS
FEMALE SKATER DETAILS
Field Moves Level:
Date passed
Field Moves Level :
Date passed
Single Competitive Free :
Date passed
Single Competitive Free :
Date passed
Single Competitive Elements :
Date passed
Single Competitive Elements :
Date passed
Pairs Competitive Short :
Date passed
Pairs Competitive Short :
Date passed
Pairs Competitive Free :
Date passed
Pairs Competitive Free :
Date passed
NISA National Pairs Test :
Date passed
NISA National Pairs Test :
Date passed

PLEASE INDICATE DETAILS OF PENDING TESTS PRIOR TO CLOSING DATE:

UK Coach Details

NISA licensed coaches wishing to enter skaters for these events must have attended the discipline specific IJS seminar at the Coaches Conference either in 2016, 2017 & 2018 to be accredited for this event. Any coach who has not yet attended the Coaches Conference may not now be accredited. Any IJS seminar prior to 2016 has now expired.

A Field Moves seminar also must have been completed prior to the date of the competition – This may have been completed prior to attendance of the Coaches Conference.

All competitors are to complete in the Primary Coach section of the form. Should you have an Accredited Coach then complete this section of the form in full as well.

Primary Coach 1 (Name):
Accredited Coach 2 (Name):
NISA Membership Number:
NISA Membership Number:
Date / Venue Conference / IJS Seminar Attended(required):
Date / Venue Conference / IJS Seminar Attended :
Date / Venue Field Moves Seminar Attended (required):
Date / Venue Field Moves Seminar Attended:

Pairs Programme Content

Event Entered:

Second Event Entered (if applicable) :



(1) ELEMENTS MUST BE IN ORDER OF SKATING

Please use the dropdown boxes to complete the Programme Elements section of the form.

Time During Programme
Programme Elements Free
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In completing the above section if you have selected 'Other' as one of your moves then please can you give more details in the box below ie the time during the programme and the element name.



ENTRY FEES: Beginner/Basic novice pairs £70 (per couple).




Before you submit this form along with your payment please provide the name of whose account the payment will be coming from in order that we can match both the form and payment:




I have read the Rules of the competition

(NOTE: You will not be registered without a completed application form.)



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