2008 JUNIOR FENCING CAMP AT PENN

PRELIMINARY CAMP APPLICATION

Applying for: _______ First Week (July 20-July 26, 2008) _______ Second Week (July 27-August 2, 2008) Gender:   ___Male         ___Female Name: _______________________________ Address: _____________________________ City, State, Zip: _______________________ Phone: (_____)-____________ E-Mail: ______________________________ School: _____________________________ Grade in September 2008: ______________ Date of Birth: ____________________ USFA Member #: __________________ USFA Division: ____________________ Fencing Club: _____________________ How long you have been fencing: ___________________________

Nonrefundable Deposits enclosed ($450 each session) Week One: $_________ Week Two: $_________ Make Checks Payable to >> David M. Micahnik << Weapon with which you wish to train at camp (one ONLY): __________________________________________ Coach’s name, address and phone#: __________________________________________ __________________________________________ __________________________________________ __________________________________________ Summary of 2004-2008 competitive record: (use additional paper if necessary): __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________

Please send this Preliminary Camp Application and a check for the
Non-Refundable $450 for each week you wish to attend.

Please mail the application and fee so that it arrives prior to June 27, 2008.
Balance of $300 per week due at check-in.

Make Checks Payable to >> David M. Micahnik << and mark it for "Junior Fencing Camp" at the bottom.