Wings of America
Nomination Form for Foot Locker
Sponsorship
Regional Races: Midwest,
Northeast, and South on Nov. 24, 2001
West on Dec. 1, 2001
Wings of America, a program
of the Earth Circle Foundation, will be sponsoring Indian High School students
to the four Foot Locker Regional Races. Use this form to nominate runners from your running program. Runners must be enrolled in a federally recognized
American Indian tribe or be able to prove ¼ Indian blood quantum to be eligible
for Wings sponsorship. Nomination forms
must be received in Wings office by November 9. Please use a pen and print to complete form. Form may be duplicated for additional nominations.
Wings will reimburse allowable expenses up to $250.00 for selected junior and high school runners to attend their regional Foot Locker Race: Midwest, Northeast, South or West. First priority will go to runners qualifying for the seeded race. The first eight finishers in boys & girls seeded races earn a trip to Foot Locker Nationals in Orlando, Florida, on December 8, 2001. Next consideration will be given to emerging runners who would benefit from competing in a regional race of this caliber. Runners are responsible for their own travel, lodging, and race registration. For more information on Foot Locker, visit http://footlockercc.com
Nomination for Footlocker:
(please check one) Yes No
Participant’s regional competition:
_______________________.
Name
of Athlete:
Birth date: Age: Circle one: M F Address: Town:
___ State: Zip: Tribal Affiliation:
Enrollment # ___ Phone: E-Mail: Fax: ___ Parent/Guardian
name:
Phone (if different):
___ Address (if different):
___ School:
Grade:
Division:
___ School Address:
___ Cross
Country Coach’s Name:
Phone:
___ Coach’s Address:
___ Coach’s Home phone:
E-Mail:
Fax:
___ - BACK Running
Stats (must be detailed and accurate) Submit
printed results, articles, etc. if available. Athlete’s
Time at State: Place of Finish: Distance:
Date: Location
& description:
Altitude:
Time
at District (or other): Place of Finish: Distance: Date: Location
& description:
Altitude:
Best
time this season:
Place of Finish: Distance:
Date: Location
& description:
Altitude: Indicate your uniform sizes: (circle one) Men
Women Singlet: ___________________ Shorts: ________________ Warm-ups: ________________ Shoes (Nike): __________ Brief information on USATF 2002 Winter
Cross Country Championships in Vancouver, Washington: Wings
is in preparation for USA Track & Field Winter Cross Country Meet scheduled
for February 9 –10, 2002. The Meet is a qualifier to World Cross Country
Championships (location to be announced). Wings anticipates a selection of six men & six women to represent
All-Indian XC Wings’ Junior teams. The
Selection is based on accomplishments during the XC season of 2001.
Pease
check the appropriate box: Signatures: Signature of athlete:
Date: Signature of parent:
Date: Signature of coach:
Date: Return form to: Wings of America, 1601 Ccrrillos Road, Santa
Fe, NM, 87505, by Nov. 9. Phone:
505-982-6761 / Fax: 505-989-8995 / E-Mail: WingsAmer@aol.com Keep a copy of your completed
from. After mailing or faxing the original
to Wings office, Please call or E-Mail to
be sure the form was received.
Section A
Section
B Stats
are very important and must be competed by your Cross Country coach!
Section C
Section D
Yes,
please consider my nomination and send a complete packet for USATF Championships.
( Athletes from ages 14 to 19 are eligible; cannot turn 20 in 2002)
No,
I will not compete at this level.