Washington
State Wrestling Association
Schoolboy/girl, Cadet and Junior National Dual Team
2004 Application
Chuck
Bullard – State Chairman
Washington
State Wrestling Association
Poulsbo,
WA. 98370-0047
For Questions contact:
(360) 297-8494 phone (360) 297-1695
fax ChuckBullard@earthlink.net
2003 WSWA Folkstyle State
Championships (Washougal)
1st Place 6 Points
2nd Place 4 Points
2003 USA Wrestling Northwest
Regionals (Battle Ground)
1st Place 7 Points
2nd Place 5 Points
2003 USA Wrestling Folkstyle
Nationals (Topeka KS)
National Champion 10 Points
All- American
6 Points
2003 WSWA Freestyle and
Greco-Roman State Championships (Sedro-Woolley) (East Valley)
1st Place 5 Points
2nd Place 3 Points
2003 Team Washington Dual
Team Member
4 Points
2003 USA Wrestling Kids/Cadet
Western Regionals (Butte MT)
1st Place 7 Points
2nd Place 5 Points
3rd Place 3 Points
2003 USA Wrestling Kids
National Championships (Enid OK)
National Champion 10 Points
All-American
6 Points
2004 WSWA Folkstyle State
Championships (Bellingham)
1st Place 12 Points
2nd Place 9 Points
3rd Place 7 Points
2004 USA Wrestling Folkstyle
National Championship (Cedar Falls IA)
National Champion 20 Points
All-
American 12 Points
2004 WSWA Freestyle and
Greco-Roman State Championships (Tumwater)
(Sedro-Woolley)
1st Place 10 Points
2nd Place 7 Points
3rd Place 5 Points
2003 WSWA Folkstyle State
Championships (Washougal)
1st Place 6 Points
2nd Place 4 Points
2003 USA Wrestling Northwest
Regionals (Battle Ground)
1st Place 7 Points
2nd Place 5 Points
2003 USA Wrestling Folkstyle
Nationals (Topeka KS)
National Champion 10 Points
All-
American 6 Points
2003 USA Wrestling Junior
West Regionals (Las Vegas NV)
1st Place 7 Points
2nd Place 5 Points
3rd Place 3 Points
2003 WSWA Freestyle and
Greco-Roman State Championships (Sedro-Woolley) (East Valley) (Vancouver)
1st Place 5 Points
2nd Place 3 Points
2003 USA Wrestling Kids/Cadet
Western Regionals (Butte MT)
1st Place 7 Points
2nd Place 5 Points
3rd Place 3 Points
2003 USA Wrestling Kids
National Championships (Enid OK)
National Champion 10 Points
All-American
6 Points
2003 Team Washington Dual
Team Member
4 Points
2003 USA Wrestling Cadet and
Junior National Championships (Fargo ND)
National Champion 10 Points
All-American 6 Points
National Team Member 2 Points
2003 Tri-State (North Idaho
Community College)
1st Place 10 Points
2nd Place 7 Points
2003 Pac-Coast (Evergreen
High School Vancouver Wa.)
1st Place 10 Points
2nd Place 7 Points
2004 WSWA Folkstyle State
Championships (Bellingham)
1st Place 12 Points
2nd Place 9 Points
3rd Place 7 Points
2004 WIAA High School State
Championships (Tacoma Dome)
1st Place 12 Points
2nd Place 9 Points
3rd Place 7 Points
2004 USA Wrestling Northwest
Regionals (Battle Ground)
1st Place 15 Points
2nd Place 12 Points
3rd Place 9 Points
2004 USA Wrestling Folkstyle
National Championship (Cedar Falls IA)
National Champion 20 Points
All- American 12
Points
2004 USA Wrestling Junior
West Regionals (Las Vegas NV)
1st Place 15 Points
2nd Place 12 Points
3rd Place 9 Points
2004 WSWA Freestyle and
Greco-Roman State Championships (Chehalis)
(Sedro-Woolley)
1st Place 10 Points
2nd Place 7 Points
3rd Place 5 Points
2003 WSWA Folkstyle State
Championships (Washougal)
1st Place 6 Points
2nd Place 4 Points
2003 USA Wrestling Northwest
Regionals (Battle Ground)
1st Place 7 Points
2nd Place 5 Points
2003 USA Wrestling Folkstyle
Nationals (Topeka KS)
National Champion 10 Points
All- American
6 Points
2003 USA Wrestling Junior
West Regionals (Las Vegas NV)
1st Place 7 Points
2nd Place 5 Points
3rd Place 3 Points
2003 WSWA Freestyle and
Greco-Roman State Championships (Sedro-Woolley) (East Valley)
1st Place 5 Points
2nd Place 3 Points
2003 USA Wrestling Kids/Cadet
Western Regionals (Butte MT)
1st Place 7 Points
2nd Place 5 Points
3rd Place 3 Points
2003 Team Washington Dual
Team Member
4 Points
2003 USA Wrestling Cadet and
Junior National Championships (Fargo ND)
National Champion 10 Points
All-American 6 Points
National Team Member 2 Points
2003 Tri-State (North Idaho
Community College)
1st Place 10 Points
2nd Place 7 Points
2003 Pac-Coast (Evergreen
High School Vancouver Wa.)
1st Place 10 Points
2nd Place 7 Points
2004 WSWA Folkstyle State
Championships (Bellingham)
1st Place 12 Points
2nd Place 9 Points
3rd Place 7 Points
2004 WIAA High School State Championships
(Tacoma Dome)
1st Place 12 Points
2nd Place 9 Points
3rd Place 7 Points
2004 USA Wrestling Northwest
Regionals (Battle Ground)
1st Place 15 Points
2nd Place 12 Points
3rd Place 9 Points
2004 USA Wrestling Folkstyle
National Championship (Cedar Falls IA)
National Champion 20 Points
All- American 12
Points
2004 USA Wrestling Junior
West Regionals (Las Vegas NV)
1st Place 15 Points
2nd Place 12 Points
3rd Place 9 Points
2004 WSWA Freestyle and
Greco-Roman State Championships (Chehalis)
(Sedro-Woolley)
1st Place 10 Points
2nd Place 7 Points
3rd Place 5 Points
Schoolboy/girl
Cadet
·
A 2nd
year Schoolboy/girl last year that moves to 1st year Cadet this
year, points in this category will be cut in half. A Cadet that competes in a
Junior Division tournament and places will receive full point value. (Example:
Cadet places 1st at Junior West Regionals in Las Vegas in Freestyle
will receive 15 points, if the wrestler uses those points in Greco-Roman the
wrestle will only get credit for 7.5 points.)
Junior
·
A 2nd
year Cadet last year that moves to 1st year Junior this year, points
in this category will be cut in half. If a Cadet chooses to compete at the
Junior tournament, Cadet points earned at a Junior tournament will have full
point value. . (Example: Cadet places 1st at Junior West Regionals
in Las Vegas in Freestyle will receive 15 points, if the wrestler uses those
points in Greco-Roman the wrestle will only get credit for 7.5 points.)
The following MUST be included with
application or it will be returned:
1)
Complete and
signed Application
(This form)
2)
Cashiers Check or
Money Order for $350.00 (no personal
checks and no cash) – Make payable to:
WSWA or Washington State Wrestling Association - $330.00 to be refunded
within one week if you do not make team.
3)
Code of Conduct Form –
SIGNED
4)
Copy of current
year USA Wrestling Card
5)
Copy of Birth
Certificate
6)
Complete and
Signed Dual Team Entry Form – Ensure it is the correct form – they are
different between the Schoolboy/girl,
Cadet, and Junior Team
7)
Sizes Specified:
a.
Jacket Size
b.
Tee Shirt Size
c.
Short Size
ANY spots not filled will be selected
and filled by the coaching staff or Team Leader.
Schoolboy/girl Application Registration Form –
Washington State National Dual Team – 2004
Name
Name for airline ticket if
different than above
Mailing Address
City State Zip Code
Phone (include area code)
Weight USA Card # Birth Date
Signature of Athlete
Signature of Parent and/or
Guardian
Print Name of Parent and/or
Guardian
2003 WSWA Folkstyle State Championships Placing _____________
2003 USA Wrestling Northwest Regional
Schoolboy/girl Freestyle Placing_________________ Schoolboy/girl Greco-Roman Placing
____________
2003 USA Wrestling Folkstyle Nationals ____________
2003 WSWA Freestyle and Greco-Roman State Championships
Freestyle Placing____________________ Greco-Roman
Placing________________
2003 Team Washington Dual Team Member____________
2003 USA Wrestling Kids/Cadet Western Regional
Freestyle Placing_____________ Greco-Roman
Placing_______________
2003 USA Wrestling Kids Nationals
Freestyle Placing_______________ Greco-Roman Placing____________
2004 WSWA Folkstyle State
Championships_________________
2004 USA Wrestling Folkstyle National Championships
Placing________________
2004 WSWA Freestyle and Greco-Roman State Championships
Freestyle Placing____________________ Greco-Roman
Placing__________________
Cadet Application Registration Form – Washington State
National Dual Team – 2004
Name
Name for airline ticket if
different than above
Mailing Address
City State Zip Code
Phone (include area code)
Weight USA Card # Birth Date
Signature of Athlete
Signature of Parent and/or
Guardian
Print Name of Parent and/or
Guardian
2003 WSWA Folkstyle State Championships Placing _____________
2003 USA Wrestling Northwest Regional
Schoolboy/girl Freestyle Placing_________________ Schoolboy/girl Greco-Roman Placing
____________
Cadet Freestyle Placing________________________ Cadet Greco-Roman Placing____________________
Junior Freestyle Placing_______________________ Junior Greco-Roman
Placing___________________
2003 USA Wrestling Folkstyle Nationals Placing
____________
2003 USA Wrestling Junior West Regional
Junior Freestyle Placing_________________ Junior Greco-Roman
Placing__________________
2003 WSWA Freestyle and Greco-Roman State Championships
Cadet Freestyle Placing____________________ Cadet Greco-Roman
Placing________________
Junior Freestyle Placing___________________ Junior Greco-Roman
Placing_______________
2003 USA Wrestling Kids/Cadet Western Regional
Freestyle Placing_____________ Greco-Roman
Placing_______________
2003 USA Wrestling Kids Nationals
Freestyle Placing_______________ Greco-Roman Placing____________
2003 Team Washington Dual Team Member____________
2003 USA Wrestling Cadet and Junior National
Championships
Cadet Freestyle Placing_______________ Cadet Greco-Roman
Placing________________
Junior Freestyle Placing______________ Junior Greco-Roman Placing_______________
National Team Member______________
2003 Tri-State Placing________________ 2003 Pac-Coast Placing_____________
2004 WSWA Folkstyle State
Championships_________________
2003 WIAA High School Placing _______________
Page
1 of 2
2004 USA Wrestling Northwest Regional
Cadet Freestyle Placing_______________ Cadet Greco-Roman
Placing______________
Junior Freestyle Placing______________ Junior Greco-Roman
Placing_____________
2004 USA Wrestling Folkstyle National Championships Cadet
Placing________________
2004 USA Wrestling Junior West Regional
Junior Freestyle Placing_________________ Junior Greco-Roman
Placing__________________
2004 WSWA Freestyle and Greco-Roman State Championships
Cadet Freestyle Placing____________________ Cadet Greco-Roman
Placing__________________
Junior Freestyle Placing___________________ Junior
Greco-Roman Placing_________________
Page
2 of 2
Junior Application Registration Form – Washington State
National Dual Team – 2004
Name
Name for airline ticket if
different than above
Mailing Address
City State Zip Code
Phone (include area code)
Weight USA Card # Birth Date
Signature of Athlete
Signature of Parent and/or
Guardian
Print Name of Parent and/or
Guardian
2003 WSWA Folkstyle State Championships Placing _____________
2003 USA Wrestling Northwest Regional
Cadet Freestyle Placing________________________ Cadet Greco-Roman
Placing____________________
Junior Freestyle Placing_______________________ Junior Greco-Roman
Placing___________________
2003 USA Wrestling Folkstyle Nationals Cadet
Placing____________
2003 USA Wrestling Junior West Regional
Junior Freestyle Placing_________________ Junior Greco-Roman
Placing__________________
2003 WSWA Freestyle and Greco-Roman State Championships
Cadet Freestyle Placing____________________ Cadet Greco-Roman Placing________________
Junior Freestyle Placing___________________ Junior
Greco-Roman Placing_______________
2003 USA Wrestling Kids/Cadet Western Regional
Cadet Freestyle Placing_____________ Cadet Greco-Roman
Placing_______________
2003 Team Washington Dual Team Member____________
2003 USA Wrestling Cadet and Junior National
Championships
Cadet Freestyle Placing_______________ Cadet Greco-Roman
Placing________________
Junior Freestyle Placing______________