30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

th 1. This Forms must be sent back to UAE Cycling Federation by 7 March 2010 to confirm your participation, along with 4 passport size recent photographs/white background, for each participants and officials, (write the names on back side). Forms received late will not be accepted.

ELITE MEN Name of Federation : Address :

Tel No. Fax No. E-Mail : UCI CODE/ EVENT SURNAME FIRST NAME PASSPORT No. LICENCE No.

Time Trial (not likely to be held)

Keirin

Team Sprint

Individual Pursuit

Point Race

1/8

30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

UCI CODE/ EVENT SURNAME FIRST NAME PASSPORT No. LICENCE No.

Scratch

Omnium

Individual Road Race

Individual Time Trial

Name of Federation :

Name of President/Secretary General:

Signature and Stamp :

Date and Place :

2/8

Page 2 of 9

30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

th 1. This Forms must be sent back to UAE Cycling Federation by 7 March 2010 to confirm your participation, along with 4 passport size recent photographs/white background, for each participants and officials, (write the names on back side). Forms received late will not be accepted.

JUNIOR BOYS Name of Federation : Address :

Tel No.

Fax No. E-Mail : UCI CODE/ EVENT SURNAME FIRST NAME PASSPORT No. LICENCE No. Sprint

Time Trial (not likely to be held) Team Pursuit

Keirin

Team Sprint

Individual Pursuit

Point Race

3/8

Page 3 of 9

30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

UCI CODE/ EVENT SURNAME FIRST NAME PASSPORT No. LICENCE No. Scratch

Individual Road Race

Individual Time Trial

Name of Federation :

Name of President/Secretary General:

Signature and Stamp :

Date and Place :

4/8

Page 4 of 9

30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

th 1. This Forms must be sent back to UAE Cycling Federation 7 March 2010 to confirm your participation, along with 4 passport size recent photographs/white background, for each participants and officials, (write the names on back side). Forms received late will not be accepted.

ELITE WOMEN Name of Federation : Address :

Tel No. Fax No. E-Mail : UCI COD E/ EVENT SURNAME FIRST NAME PASSPORT No. LICENCE No. Sprint

Time Trial (not likely to be held) Team Pursuit

Team Sprint

Individual Pursuit

Point Race

5/8

Page 5 of 9

30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

UCI CODE/ EVENT SURNAME FIRST NAME PASSPORT No. LICENCE No. Scratch

Omnium

Individual Road Race

Individual Time Trial

Name of Federation :

Name of President/Secretary General:

Signature and Stamp :

Date and Place :

6/8

Page 6 of 9

30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

th 1. This Forms must be sent back to UAE Cycling Federation by 7 March 2010 to confirm your participation, along with 4 passport size recent photographs/white background, for each participants and officials, (write the names on back side). Forms received late will not be accepted.

JUNIOR GIRLS Name of Federation : Address :

Tel No. Fax No. E-Mail : UCI CODE/ EVENT SURNAME FIRST NAME PASSPORT No. LICENCE No. Sprint

Time Trial (not likely to be held) Team Pursuit

Team Sprint

Individual Pursuit

Point Race

7/8 Page 7 of 9

30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

UCI CODE/ EVENT SURNAME FIRST NAME PASSPORT No. LICENCE No. Scratch

Individual Road Race

Individual Time Trial

Name of Federation :

Name of President/Secretary General:

Signature and Stamp :

Date and Place :

8/8

Page 8 of 9

30 th Asian Cycling Championships 17 th Asian Junior Cycling Championships 8 - 17 April 2010, UAE

ENTRY FORM BY NAME

th 1. This Forms must be sent back to UAE Cycling Federation by 7 March 2010 to confirm your participation, along with 4 passport size recent photographs/white background, for each participants and officials, (write the names on back side). Forms received late will not be accepted.

OFFICIALS Name of Feder ation : Address : Tel No. : Fax No. : E-Mail : Title SURNAME FIRST NAME Gender (M/F) PASSPORT No. Chief/Deputy Chief of the Delegation Team Manager

Coach

Mechanic

Doctor Masseur

Interpreter Others

Name of Federation :

Name of President/Secretary General:

Signature and Stamp :

Date and Place :

Page 9 of 9