EmailMe Form - PVS - TRAVEL ASSISTANCE Application -part 1

SUBMITTING CLUB *

Contact Email *

Meet Name *

Please include Year (ex. 2015 Junior National Champs)

Meet Start Date *

MM / DD / YYYY

Meet End Date *

MM / DD / YYYY

Swimmers & Events:
Qualification list available at http://www.pvswim.org/trvassti.htm

Swimmer's Name 1

USAS ID

Eligibility

Qualified

Appeals

Explanation of Appeal

Event

Swimmer's Name 2

USAS ID

Eligibility

Qualified

Appeals

Explanation of Appeal

Event

Swimmer's Name 3

USAS ID

Eligibility

Qualified

Appeals

Explanation of Appeal

Event

Swimmer's Name 4

USAS ID

Eligibility

Qualified

Appeals

Explanation of Appeal

Event

Swimmer's Name 5

USAS ID

Eligibility

Qualified

Appeals

Explanation of Appeal

Event

Agreement

I attest that the above athlete(s) have met all established PVS Travel Assistance eligibility requirements , including the prescribed meet participation requirements, and have participated in an individual event in the meet indicated above. I have also attached a meet participation certification form for each athlete listed in another forms.

*

I agree.

I don't agree.

Name *

First Last

By signing this application I verify that the above is true and correct.

Swimmers & Events: Qualification list available at http://www.pvswim.org/trvassti.htm

Agreement

Swimmers & Events:
Qualification list available at http://www.pvswim.org/trvassti.htm