<p> DELEGATION’S NOMINAL INSCRIPTION FORM COACHES AND OFFICIALS</p><p>FEDERATION: CONTACT PERSON POSITION PHONE NUMBER EMAIL</p><p>COACHES / OFFICIALS Name/Surname Function 1. 2. 3. 4. 5.</p><p>Referees Licence IFJ - A  / B  / National  IFJ - A  / B  / National </p><p>OTHERS Name Function 1. 2. 3.</p><p>Attention: </p><p>1. Only inscriptions filled and confirmed by national federations will be accepted.</p><p>2. This form must be returned to the Portuguese Judo Federation ([email protected]) before March 3 rd 2017.</p><p>3. Entry should be entered in the Jumas system by not later 13th March 2017.</p><p>Date: __/__/__ Head of the Delegation's Signature & Federation's Stamp: ______Head Office Vienna1200 Vienna, Austria Wehlistrasse 29/1/111 1200 Vienna, Austria</p><p>DELEGATIONS’ NOMINATIVE INSCRIPTION FORM WOMEN</p><p>FEDERATION:</p><p>Weight Training Camp Family name First name Date of birth Best results category (Yes/No) 1. 2. 44 kg 3. 4. 1. 2. 48 kg 3. 4. 1. 2. 52 kg 3. 4. 1. 2. 57 kg 3. 4. 1. 2. 63 kg 3. 4. 1. 2. 70 kg 3. 4. 1. 2. 78 kg 3. 4. 1. 2. +78 kg 3. 4. 1. This form must be returned to the Portuguese Judo Federation ([email protected]) before March 3 rd 2017.</p><p>2/5 Head Office Vienna1200 Vienna, Austria Wehlistrasse 29/1/111 1200 Vienna, Austria</p><p>Date: __/__/__ Head of the Delegation's Signature & Federation's Stamp: ______DELEGATIONS’ NOMINATIVE INSCRIPTION FORM MEN</p><p>FEDERATION:</p><p>Weight Family name First name Date of birth Best results Training Camp (Yes/No) category 1. 2. -55 kg 3. 4. 1. 2. -60 kg 3. 4. 1. 2. -66 kg 3. 4. 1. 2. -73 kg 3. 4. 1. 2. -81 kg 3. 4. 1. 2. -90 kg 3. 4. 1. 2. -100 kg 3. 4. 1. 2. +100 kg 3. 4. 1. This form must be returned to the Portuguese Judo Federation ([email protected]) before March 3 rd 2017.</p><p>Date: __/__/__ Head of the Delegation's Signature & Federation's Stamp: ______</p><p>3/5 Head Office Vienna1200 Vienna, Austria Wehlistrasse 29/1/111 1200 Vienna, Austria</p><p>FLIGHT SCHEDULE FEDERATION:</p><p>ARRIVAL</p><p>PLANE / TRAIN Airport/railway Persons Date Time Flight number From station arrival number</p><p>Car / bus Date Time Persons number</p><p>DEPARTURE</p><p>PLANE / TRAIN Airport/railway Persons Date Time Flight number From station arrival number</p><p>Car / bus Date Time Persons number</p><p>1. This form must be returned to the Portuguese Judo Federation ([email protected]) before March 3 rd 2017.</p><p>Date: __/__/__ Head of the Delegation's Signature & Federation's Stamp: ______</p><p>4/5 Head Office Vienna1200 Vienna, Austria Wehlistrasse 29/1/111 1200 Vienna, Austria</p><p>VISA APLICATION FORM</p><p>FEDERATION:</p><p>Arrival Date: Departure Date:</p><p>We will apply for the Visas at ______Embassy in______(City/Country).</p><p>Surname First Name Position Date of Birth Place of Birth Nationality Passport Nº Date of Issue Date of Expiry</p><p>This form must be returned to the Portuguese Judo Federation ([email protected]) before February 24 th 2017</p><p>Date: __/__/__ Head of the Delegation's Signature & Federation's Stamp: ______</p><p>5/5</p>