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National Federation

NF Contact

E-mail :

Name /detai ls of proposed athlete

Family name: F irs t Name:

Date of Bir th: dd mm yyyy Gender: Male Female

E-mai l :

Head Coach of proposed athlete

Family name: F irs t Name:

E-mai l :

TEAM ITU - Event being Applied for (mark yes/no)1. 2015 Chengdu ITU Tr iathlon World Cup

date : 9 - 10 May , fo rmat : s tand ard d i s tance Yes No

2. 2015 Huatulco ITU Tr iathlon World Cup date : 2 6 J u l y , f ormat : spr i nt d is t ance

Yes No

3. 2015 Tiszaujvaros ITU Triathlon World Cup date : 8 - 9 Augus t , fo rmat : spr i nt d i s tance (SF/F )

Yes No

4. 2015 Alanya ITU Triathlon World Cup date : 1 7 -1 8 Oct ober , f or mat : s t andar d d i s ta nce

Yes No

Athlete - background in sport*

How many years have you participated in other sports before starting tr iathlon?

Sport: Years in sport:

Sport: Years in sport:

How many years have you participated in Triathlon?

Current train ing f requency & volume Current km’s per week

Current Sessions per week

Swim

Bike

Run

ITU D ev e l opment │TEAM I TU E l i te Ath l ete Dev e lo pment P ro ject 20 15

T E A M I T U E L I T E A T H L E T E D E V E L O P M E N T P R O J E C T 2 0 1 5

Athlete - Pr imary sporting achievement*

Event Result Date (yyyy) Place

* N F s c a n s u p p l e m e n t t h i s i n f o r m a ti o n w i t h t h e a t h l e t e ’ s s p o r ti n g C V i f a v a i l a b l e

Athlete - Participation in ITU and/or Continental Development Projects

Have you participated in any ITU or Continental Development Projects (scholarship, camp, Team ITU)? Yes No

If , yes… please speci fy .

Project Where? When?

Optional Attachments (wi l l fac i l i tate approval procedure i f submitted)

Enclosed

1. Long Term Strategic Plan of the National Federation Yes No

2. Detai led sporting curr iculum of ath lete Yes No

3. Copy of ath lete’s passport Yes No

I , the unders igned, certify that the information prov ided above is accurate.

( N a m e , F u n c ti o n a n d S i g n a t u r e ) ( D a t e )

Plea se su bmit the ap pl i c ati on f orm to Z i ta Cso vel ya k a t z i ta@tr ia th lo n.org o n o r be fo re d ue da tes .

ITU D ev e l opment │TEAM I TU E l i te Ath l ete Dev e lo pment P ro ject 20 15

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