(Eff. 9/27/03)
The Skating Club of Wilmington, Inc.

                This Page can be printed out, filled in, and sent to the Club as a test Application. Fill in all the 
                required entries, get all the required signatures, and send it to the Club with your remittance.


For Office Use Only: Date Rec'd _________
$ ________________ Check # __________
Approved _________

Candidate's Name ________________________________________ USFSA Number _________________

Address _____________________________________________________ Telephone No. ______________

E-Mail Address __________________________________________ Fax No. ________________________

Name of Club through which you are registered with USFSA ___________________________________________________
A tester not registered with the USFSA through SCW must submit a permission-to-test letter from his/her Home Club.
SCW affiliation - Please check one.
                                                                None _____   Representational _____

SCW Member: (Low/Standard use) ____   SCW Member: (Light Use/Tickets) ____   SCW Member: Basic only ____

COMPULSORY DANCE TESTS AND FEES for each dance. Please circle dances to be taken. 
Please check in the appropriate space if you are testing under the ADULT, MASTER or SOLO ONLY basis.
Preliminary $10 DW CT RB Solo Only ___
Pre Bronze $10 SD CC FiT Master ___  Solo Only ___
Bronze $15 HH WiW TF Master ___ Solo Only ___
Pre Silver $15 14S EW FT  Adult ___ Master ___ Solo Only ___
Silver $20 AW T RF  Adult ___ Master ___ Solo Only ___
Pre Gold $25


BL PD SW  Adult ___ Master ___ Solo Only ___
Gold $30 VW WW QS AT Adult ___ Master ___ Solo Only ___
International $35 AUS CON GW MB $10
(2nd candidate)
   Adult ___     Master ___
FREE DANCE TESTS AND FEES   Please check in the appropriate space if you are testing under the MASTER basis.
Juvenile____           $10 (1st candidate)   $5 (2nd candidate)
Intermediate  ____  MASTER    ____  $20 (1st candidate) $10 (2nd candidate)
Novice____ MASTER____ $30 (1st candidate)   $15 (2nd candidate)
Junior____ MASTER____ $40 (1st candidate) $20 (2nd candidate)
Senior____ MASTER____ $50 (1st candidate) $25 (2nd candidate)

Late Application Fee for All Skaters: $20. SCW Low/Standard use members and SCW Coaches pay no extra 
Ice Fee. SCW Light Use, Ticket & Basic members pay an extra $8 per dance for Silver compulsory dances and higher, 
$4 per dance
for dances below Silver. All other testers pay an extra $15 per dance for Silver compulsory dances and 
higher, $7 per dance for compulsory dances below Silver. Each non-member Free Dance candidate must pay an 
extra $10 per free dance.
Dance Partner's Name _______________________________________ Home Club _________________________________

ALL APPLICATIONS MUST BE SIGNED BY APPLICANT'S COACH, and, in case of a child under 12, by parent or guardian.

Coach's Signature ________________________ Coach's E-mail ______________________ Coach's Phone _____________

Parent's or Guardian's Signature (only if child is under age 12) _________________________________________________

Please make checks payable to "The Skating Club of Wilmington, Inc." Mailing address: 1301 Carruthers Lane, 
Wilmington, DE  19803. In order for tests to be scheduled, both the application and the fees must be received by the office  
no later than the posted Test Deadline date. Applications submitted without fees will not be scheduled.
Skaters may cancel 
tests but fees are not refundable. Please write any special circumstances or requests on the bottom of this form.

                  Questions, comments, or problems? Contact:  Webmaster

Updated 9/27/03