W INTER C LUB OF I NDIANAPOLIS T EST A PPLICATION Skater: ________________________________________ E - mail: ________________________________________ Coach ’s Signature: _______________________________ USFS Membership #: _________________________ Phone N umber: ______________________________ Home Club: _________________________________ Moves in the Field Pre - Preliminary $35 Preliminary $40 Pre - Juvenile $45 Juvenile $50 Intermediate $55 Novice $60 Junior $65 Senior $70 Adult Moves in the Field Pre - Bronze $30 Bronze $40 Silver $45 Gold $50 Pairs Test (per partner ) Preliminary $20 Juvenile $20 Intermediate $25 Novice $30 Junior $40 Senior $45 Free Skate Pre - Preliminary $20 P reliminary $30 Pre - Ju venile $35 Juvenile $40 Intermediate $45 Novice $50 Junior $55 Senior $60 Adult Free Skate Pre - Bronze $20 Bronze $25 Silver $30 Gold $35 Free Dance (per partner) Juvenile $30 Intermediate $35 Novice $40 Junior $45 Senior $50 Dance (price per dance) Standard Masters Adult Solo Preliminary $20 Per dance Dutch Waltz Canasta Tango Rhythm Blues Pre - Bronze $25 Per dance Cha Cha Fiesta Tango Swing Dance Bronze $30 Per dance Hicko ry Hoedown Willow Waltz Tenfox Pre - Silver $35 Per dance 14 Step Foxtrot European Waltz Silver $40 Per dance Rocker Foxtrot Tango American Waltz Pre - Gold $45 Per dance Kilian Blues Paso Doble Starlight Waltz Gold $5 0 Per dance Argentine Tango Quickstep Vie n nese Waltz Westminster Walt z International $50 Per dance Rhumba Midnight Blues Tango Romantica Cha Cha Congelado Silver Samba Ravensburger Waltz Golden Waltz Finnstep Yankee Polka Skate rs who are not part of Winter Club of Indianapolis or an Indiana Council Member Club, must pay a $25 guest fee. All skaters must pay an $10 hospitality fee. Refunds will not be given 7 days prior to the test except due to injury, illness, or extraordinary family emergency. Applications and payment are due 2 weeks prior to test date All tests subject to availability and expenses related to judges. Please complete and give to Test Chair or mail to: Andrea Yovanovich 9779 Briarway Lane, McCordsville, IN 46055. Total Fees Hospitality $ 10 .00 MIF Fees $ FS Fees $ Dance Fees $ Pairs Fees $ Guest Fees $ Total Testing $