Expression of Interest for Cycling Ireland U23 Programme 2020.

Cycling Ireland U23 Programme 2020

The following form is an opportunity to express interest in racing for Cycling Ireland U23 Programmes in 2020.

This expression of interest is for Riders of the below category:

U23 - Born 1998 - 2001

This application is only an expression of interest and does not guarantee selection for any U23 races. The purpose of this form is to allow programme coaches to build a bank of riders eligible to represent Cycling Ireland.

For general information on Cycling Ireland Selection Policy, please visit: http://www.cyclingireland.ie/downloads/cyclingirelandhpselectionpolicy2020.pdf

For information on Cycling Ireland's calendar of proposed races visit: http://www.cyclingireland.ie/page/high-performance/high-performance-scheduled-events

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* 1. Applicant's Name (Forename & Surname):

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* 2. Applicant's Date of Birth:

Date

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* 3. Applicant's age:

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* 4. Applicant's address:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 5. Please select which of the following categories you fit.

U23 Male

U23 Female

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* 6. What is the name of your current club?

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* 7. Please specify the discipline(s) you currently compete/train in.

Road

Track

Off-Road

BMX

Paracycling

Other (please specify)

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* 8. Please indicate where you are based in 2020.

Ireland

Belgium

France

Other (please specify)

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* 9. Please provide detail of your 2019 racing career.

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* 10. Please provide your goals and targets for 2020.

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* 11. I understand that this application is only an expression of interest and does not guarantee any selection for U23 Races.

Yes

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* 12. I declare that all the information that I have included in this application is true and accurate to the best of my knowledge.

Yes

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* 13. I understand that my application will be held on a protected Cycling Ireland server.

Yes

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* 14. Please upload the applicant's signature and the date of signing.

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