2000 CONNECTICUT SWIMMING INC.

LONG COURSE ZONE TEAM

 

PRE-APPLICATION

 

The 2000 Eastern Long Course Zone Swimming Championships will be held in Buffalo at two different sites. The 9-12 year olds will swim at the University of Buffalo Alumni Arena Pool and the 13 and overs will swim at the Erie Community College Aquatic Center. All finals will be held at the Erie pool.  Dates: August 9 - 12, 2000.  

 

ALL 14/U SWIMMERS:  The Zone Coordinator must receive this form by July 15, 2000 in order to be considered for the 2000 LC Zone Team. Please note that any qualifying times you swim in meets after July 15th can still be used for zone entry times BUT this form must be submitted by the 15th in order for you to attend zones. No one will be granted a place on the zone team who does not pre-apply by July 15th. 

 

NAME:                  _______________________________________________________________________

Last                        First                        Middle Initial                        Nickname/Name on CSI entries        

 

ADDRESS:            _______________________________________________________________________

CITY/STATE:       _______________________________________________________________________

 

HOME PHONE: (      )_________________   BUSINESS PHONE:  (      )____________________

 

PARENTS EMAIL ADDRESS:         

               

 

AGE AS OF 8/9/00:  ________         DATE OF BIRTH:  _____________                SEX:   M   F

USA NUMBER:   _________________                        

 

TEAM:  ________________________________                                                      TEAM CODE:  ________

COACH’S NAME:  _____________________________________________________________________           

COACH’S PHONE:  (     )____________________                                                     

Explanation of USA number: it is the 6 digits of your birthdate – e.g. April 27, 1989  =  042789

Followed by the first three letters of your first name, your middle initial and the first four letters of your last name.

 

Zone Team Coordinator

Ben Wallace

18 Harwood Drive

Danbury CT 06810

Telephone: 203 790-8569

 

 

 

I have read and understand the 2000 Long Course Zone Team Selection Criteria and Pre-Application Forms.

 

I understand the Pre-Application Form must be received no later than July 15th, 2000. The Zone Team Coordinator is not responsible for misdirected mail; however, if you wish to verify that your application has been received, you may call Ben Wallace at (203) 790-8569.

 

I understand no further applications for the Zone Team will be accepted/considered for 14 & Under Swimmers if this form is not submitted to the Zone Coordinator by July 15th, 2000.  Send Pre-Application Form to Ben Wallace,  18 Harwood Dr, Danbury CT 06810. No phone applications will be accepted but you can submit by fax at (203) 359-3669.

 

SWIMMER’S SIGNATURE:                                                                                               

DATE:                                                                 

 

 

PARENT’S SIGNATURE:                                                                         

DATE: