Form dominica 99

fedojudo.jpg (6357 bytes)

FEDERACIÓN DOMINICANA DE JUDO INC. (FEDOJUDO)
CENTRO OLÍMPICO JUAN PABLO DUARTE
APARTADO 1110, SANTO DOMINGO
DISTRITO NACIONAL, REPÚBLICA DOMINICANA
TEL (809) 562-6067- FAX:(809) 540 - 3017
TELEX: (326) 4297 RCA CODOM

6^th. Panamerican Judo Circuit
V^th International Cup FEDOJUDO
V^th Central American and Caribbean Championships
10 - 14 June of 1999

FIRST WARNING

( ) IT DOESN´T PARTICIPATE

( ) IT PARTICIPATE

                                                               NUMBER OF OFFICIAL                     (       )
                                                               NUMBER OF COMPETITOR             (       )
                                                               NUMBER OF PARTICIPATES            (       )
                                                               OTHERS                                                 (       )
                                                                                                TOTAL                    (       )

NAME OF THE FEDERATION: _________________________________________

TELEPHONE: _________________________________________

FAX: _________________________________________

SIGNATURE: __________________________________________

DATE: _________________________________________

*THIS APPLICATION WILL BE SENT TO MORE TO TAKE APRIL 20 1999 *

DEFINITIVE INSCRIPTION

PARTICIPATES:

OFFICIAL 1.___________________

COACHES 1.___________________

2.___________________

REFEREES 1.___________________ IJF A( ) B( )

2.___________________

COMPETITORS:
MALE:

Categories	Name	Last Name	Born	Degree
-55 Kg.
+55 until -60 Kg
+60 until -66 Kg
+66 until -73 Kg
+73 until -81 Kg
+81 until -90 Kg
+90 until -100 Kg
+ 100 Kg
Open

FEMALE

Categories	Name	Last Name	Born	Degree
-44 Kg.
+44 until -48 Kg
+48 until -52 Kg
+52 until -57 Kg
+57 until -63 Kg
+63 until -70 Kg
+70 until -78 Kg
+ 78 Kg
Open

*This inscription will be a correspondent to more to take May 20 1999 *
*.To annex 1 photocopy 2 x 2" (type identification card) for each participant*

TRAVEL SCHEDULE

FEDERATION:_____________________________________

ARIVAL

DATE	TIME	FLIGHT Nº	AIRLINE

DEPARTURE
DATE	TIME	FLIGHT Nº	AIRLINE

DATE:______________________

PRESIDENT SIGNATURE:_____________________

*THIS TRAVEL SCHEDULE TO BE TETEUNED BY JUNE 5, 1999 .*