National Junior Cycling Squad 2016

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* 1. Please enter your personal information below

Name

Address

Phone number

Email address

Date of birth

Place of birth

Licence number

Club / team (if any)

Number of years competing

Height and weight

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* 2. Name of coach (if any, please include contact details - phone number or email)

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* 3. How do you record your training diary (i.e. written diary, Training Peaks etc)

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* 4. Racing achievements in the previous year (please include any relevant track times)

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* 5. Goals and targets: please specify your main goals for the coming season and also your long term goals

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* 6. Please explain why you would like to be accepted on the National Junior Squad, and how you believe Cycling Ireland can help you improve by being accepted on to the squad.

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* 7. Statement by applicant

I understand that this application does not guarantee a place on the National Squad and that places will be strictly limited. I declare that all the information that I have included in this application is true and accurate to the best of my knowledge

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* 8. Please tick this box to confirm that a Parent / Guardian consents to this application being submitted

I can confirm that a Parent / Guardian consents to this application being submitted

Please note that you must currently hold an Irish passport to represent Ireland