*Joint Project in America / Joint Project in Asia

T E A M T E A M I T U 2 0 1 7 – I T U D E V E L O P M E N T P R O J E C T

National Federation

NF Contact

E-mail:

Name /details of proposed athlete Family name: First Name: Date of dd mm yyyy Gender: Male Female Birth: E-mail:

Head Coach of proposed athlete Family name: First Name: E-mail:

TEAM ITU - Event being Applied for (mark yes/no) 2017 Chengdu ITU Triathlon World Cup Yes No date: 6-7 May, format: semi-finals-finals 2017 Madrid ITU Triathlon World Cup Yes No date: 27-28 May, format: sprint distance 2017 Tiszaujvaros ITU Triathlon World Cup Yes No date: 22-23 July, format: semi-finals-finals 2017 Salinas ITU Triathlon World Cup* date: 28-29 October, format: standard distance Yes No 2017 Buenos Aires ITU Triathlon World Cup* date: 4-5 November, format: sprint distance 2017 Tongyeong ITU Triathlon World Cup** date: 28-29 October, format: sprint distance Yes No 2017 Miyazaki ITU Triathlon World Cup** date: 4-5 November, format: standard distance *joint project in America / ** joint project in Asia Athlete - background in sport*

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

Sport: Years in sport:

How many years have you participated in Triathlon?

Current km’s per Current Sessions per Current training frequency & volume week week

ITU Development │TEAM ITU │ Elite Athlete Development Project │ 2017 T E A M T E A M I T U 2 0 1 7 – I T U D E V E L O P M E N T P R O J E C T

Athlete - Primary sporting achievement* (TWO RESULTS MUST BE AT CONTINENTAL CUP EVENT IN THE LAST 12 MONTHS) Event Result Date (yyyy) Place

* NFs can supplement this inform ation with the athlete’s sporting CV if available

Athlete - Participation in ITU and/or Continental Development Projects

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

If, yes… please specify.

Project Where? When?

Optional Attachments Enclosed (will facilitate approval procedure if submitted) 1. Long Term Strategic Plan of the National Federation Yes No 2. Detailed sporting curriculum of athlete Yes No 3. Copy of athlete’s passport Yes No

Nomination for Coaching Support Nominated Coach:

ITU Development │TEAM ITU │ Elite Athlete Development Project │ 2017 T E A M T E A M I T U 2 0 1 7 – I T U D E V E L O P M E N T P R O J E C T

Family name: First Name: Coach’s E-mail: Project(s) nominated for (Please use YES or NO in your answer): 2017 Chengdu ITU Triathlon World Cup 2017 Madrid ITU Triathlon World Cup 2017 Tiszaujvaros ITU Triathlon World Cup 2017 Salinas ITU Triathlon World Cup* 2017 Buenos Aires ITU Triathlon World Cup* 2017 Tongyeong ITU Triathlon World Cup** 2017 Miyazaki ITU Triathlon World Cup**

*joint project in America / ** joint project in Asia

I, the undersigned, certify that the information provided above is accurate.

(Name, Function and Signature) (Date)

Please submit the application form to Zita Csovelyak at [email protected] on or before due dates.

ITU Development │TEAM ITU │ Elite Athlete Development Project │ 2017