EAP participation request in the EAP meeting
:
mandatory field
1 - DIRECT CONTACT
The Email address where I can be reached
Name
2 - PERSONAL DATA
I am
Please select
An athlete
A Coach
A manager
A friend / family
Other
Club / Federation / Organization
Date of birth
citizen of
Select your native country
United States
United Kingdom
Canada
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua And Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia And Herzegowina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo Democratic Republic
Cook Islands
Costa Rica
Cote Divoire
Croatia Hrvatska
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Heard Islands
Vatican City
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Lao
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Saint Kitts And Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia Islands
Spain
Sri Lanka
St Helena
St Pierre Miquelon
Sudan
Suriname
Svalbard Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands British
Virgin Islands US
Wallis Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zambia
Zimbabwe
Licence n° (if any)
Member of the EAP circuit ?
Yes
No
3 - EVENTS
I want to compete in the
Please select
Nat. or pre-programme
Internat. programme
Both programmes
I don't know
Category
Please select
Men
Women
Youth men
Youth women
Event 1
Please select
60m
100m
200m
300m
400m
600m
800m
1000m
1500m
Handisport
Mile
2000m
3000m
5000m
10000m
Walk race
60m hurdles
100m hurdles
110m hurdles
400m hurdles
2000m steeple
3000m steeple
4x100m
Long jump
Triple Jump
High Jump
Pole vault
Javelin Throw
Hammer Throw
Discus Throw
Shot put
Others
Perf. 1
00.00.00
Event 2
A second event ?
60m
100m
200m
300m
400m
600m
800m
1000m
1500m
Handisport
Mile
2000m
3000m
5000m
10000m
Walk race
60m hurdles
100m hurdles
110m hurdles
400m hurdles
2000m steeple
3000m steeple
4x100m
Long jump
Triple Jump
High Jump
Pole vault
Javelin Throw
Hammer Throw
Discus Throw
Shot put
Others
Perf. 2
00.00.00
Event 3
A third event ?
60m
100m
200m
300m
400m
600m
800m
1000m
1500m
Handisport
Mile
2000m
3000m
5000m
10000m
Walk race
60m hurdles
100m hurdles
110m hurdles
400m hurdles
2000m steeple
3000m steeple
4x100m
Long jump
Triple Jump
High Jump
Pole vault
Javelin Throw
Hammer Throw
Discus Throw
Shot put
Others
Perf. 3
00.00.00
Event 4
A fourth event ?
60m
100m
200m
300m
400m
600m
800m
1000m
1500m
Handisport
Mile
2000m
3000m
5000m
10000m
Walk race
60m hurdles
100m hurdles
110m hurdles
400m hurdles
2000m steeple
3000m steeple
4x100m
Long jump
Triple Jump
High Jump
Pole vault
Javelin Throw
Hammer Throw
Discus Throw
Shot put
Others
Perf. 4
00.00.00
3
a
-
Additional information on events or Performances
(PB, results on national, continental or World championships) ?
...
4 - HOW TO CONTACT ME
Address where I can be reached
This address is
my personal address
my daily address
the address of a friend/coach,etc.
the address of the club/manager,etc.
Another Email address where I can be reached
The phone number where I can be reached
Another phone number where I can be reached
The fax number where I can be reached
Another fax number where I can be reached
Other contact number ?
4a -
Additional remarks or comments on
address and contact points ?
...
5 -
THE EAP POLICY IS TO ENGAGE DRUG-FREE ATHLETES,
EXCLUSIVELY
!
Adhere to the EAP Code of Conduct :
Please select
Yes, I declare I'm DRUG-FREE and adhere to the EAP code of Conduct
Please contact me
Please note: this form is
ONLY A PRE-REGISTRATION REQUEST
.
The organizer needs to confirm your participation first !
Do not copy this form without permission
© EAP 2016