2020 Para-Cycling Next Gen Application Form
The Para-cycling NextGen program is focused on supporting a wide range of athletes throughout the development pathway, to create a World Class Para-Cycling program that will be medal competitive by the Paris 2024 Paralympic Games. Underpinning this pathway, will be a committed development and NextGen program for emerging talent supported by world-class infrastructure and creating a long-term career pathway towards international competitiveness.
APPLICANT INFORMATION
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Date of Birth (MM-DD-YYYY)
-
Month
-
Day
Year
Date
APPLICATION BASED ON THE FOLLOWING CRITERIA
Have you ever met Sport Canada Carding criteria in cycling or another sport?
Yes
No
If yes, to the question above, please provide details:
Athlete Goals - 12 month projection:
Athlete Goals - 5 year projection:
REFERENCES (PREVIOUS COACH AND PROGRAM)
Coach Name
First Name
Last Name
Company
Email
example@example.ca
Phone Number
-
Area Code
Phone Number
Club / Team
Level of racing
Number of race days (2019)
Km (2019)
1 minute Critical Power
Watts
Comments / Where / When / Power Meter Used
Regarding 1 minute Critical Power
4 minute Critical Power
Watts
Comments / Where / When / Power Meter Used
Regarding 4 minute Critical Power
20 minute Critical Power
Watts
Comments / Where / When / Power Meter Used
Regarding 20 minute Critical Power
PREVIOUS SIGNIFICANT RESULTS
Time Trials, Road Race, or Track (Provide at least the 2 previous seasons if possible)
Significant Result 1
Please provide Event Name, Date, and Result
Significant Result 2
Please provide Event Name, Date, and Result
Significant Result 3
Please provide Event Name, Date, and Result
Significant Result 4
Please provide Event Name, Date, and Result
Significant Result 5
Please provide Event Name, Date, and Result
Significant Result 6
Please provide Event Name, Date, and Result
Submit
Should be Empty: