USA Pro Cycling Challenge Race Experience Application

1. CTS USA Pro Cycling Challenge Race Experience Application

17% of survey complete.

To be eligible for the 2012 CTS USA Pro Cycling Challenge Race Experience, you must complete the entire survey. Applicants must be 18 years old or older to be considered. The cost of participating in this package will be $10,500. There are no fees for applying. Complete details on this once-in-a-lifetime experience can be found at http://www.trainright.com/upcc-2012

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* 1. Personal Information

Name: *

Company:

Address: *

Address 2:

City/Town: *

State: *

ZIP/Postal Code: *

Country: *

Email Address: *

Phone Number: *

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* 2. Date of Birth (mm/dd/yy)

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* 3. Gender:

Male

Female

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* 4. Height (please indicate feet/inches or meters/centimeters)

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* 5. Current Weight (indicate pounds or kilograms, please)

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* 6. Current profession: (feel free to describe your job in a few sentences)

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* 7. Highest level of education you completed:

High School

Some College

Undergraduate Degree

Masters Degree

PhD, MD, JD

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* 8. Household income:

<$50,000

$50-100,000

$100-500,000

>$500,000

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* 9. Marital Status:

Single

Married/Committed Relationship

Divorced

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* 10. Does your family know you’re planning on participating in this Race Experience?

Yes

Not Yet

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* 11. Does your family support your training and event goals?

They’re 100% behind me

They’re supportive as long as training doesn’t disrupt their lives

They don’t care either way

They think I’m crazy, but let me do my own thing

My training is a major stressor within my family