Adaptive Program - Interest Form

Thank you for your interest in the U.S. Figure Skating Adaptive Program! Please tell us more about yourself and your organization by completing the form below. We will be in touch with more information.

If you have questions or need assistance, please contact Susi Wehrli McLaughlin at swehrli@usfigureskating.org.

First Name *

Last Name *

Email address *

Phone number *

Name of the organization you represent *

State your organization is located in *

What is your role at this organization? *

Who would run the Adaptive programs at your facility? *

Are there currently Adaptive programs at your facility? *

Yes

No

Not sure

Other (please explain) Other (please explain)

Please mark all current programs you are offering. *

Which programs are you interested in implementing? *

What are the names of the Adaptive programs at your facility? *

In your own words, please tell us how skaters in your facility learn about Adaptive programming? *

Is there anything else you would like us to know?