2018 UCI Pam American Track Championship Discretionary Petition

Use this form to petition for the 2018 UCI Pan American Track Championships
Toluca, Mexico
August 29-September 2, 2018

Question Title

* 1. Name

First Name

Last Name

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* 2. Contact Information

Phone Number

Address

City

State

Zip Code

Emergency Contact Name

Emergency Contact Number

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* 3. Racing Information

Date of Birth

USAC License Number

UCI 11 Digit Code

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* 4. Women's event for consideration

Women's Team Pursuit

Women's Team Sprint

Women's Scratch

Women's Sprint

Women's Omnium

Women's 500 TT

Women's Individual Pursuit

Women's Madison

Women's Keirin

Women's Points Race

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* 5. Men's event for consideration

Men's Team Pursuit

Men's Team Sprint

Men's Scratch

Men's Sprint

Men's Omnium

Men's Kilo TT

Men's Individual Pursuit

Men's Madison

Men's Keirin

Men's Points Race

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* 6. Current Race Results

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* 7. Current National Ranking

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* 8. Current UCI Ranking

Question Title

* 9. Enter any additional comments here.

If you have any questions about the petition process, please contact Scott Schnitzspahn at sschnitzspahn@usacycling.org.