WORLD DRUG-FREE POWERLIFTING FEDERATION,
Inc. Annual Membership Application form:
Complete this
form, attach requested enclosures and mail to the WD.F.P.F. Secretary General
who will record, process and forward the information to appropriate W.D.F.P.F.
Officers and to the W.D.F.P.F. membership.
Required membership enclosures include:
_____ a. Laboratory evidence of Out-of competition Drug Testing program
done since November 18th, 2007.
_____ b.
A copy of the organization’s By-Laws/Constitution, unless already on
file.
_____ c. A copy of the organization’s rulebook,
unless already on file, or a statement indicating that you r nation
will use the WDFPF Rulebook.
_____ d. A copy of the organization’s membership
registration list, including contact information, from January
through
December of 2007.
_____ e. A listing of names, phone, fax, e-mail
& postal information of your International Referees.
_____ f. Dues payment of 100 EURO for the nation,
plus 1 EURO per member of the previous registration year.
For nations hosting WDFPF European or World Championships, please
include 100 EURO for Sanction Fees.
_____ g. A statement agreeing to follow all
W.D.F.P.F. rules and regulations, including agreement to Target Drug
Testing and Out-of Competition
drug testing. (This statement may be
combined with “c.” above.)
This completed
form along with the materials listed above may be sent to the Secretary General
or hand-delivered in total before 10:00 a.m. on November 21st.or a
MIMIMUM of 3 MONTHS prior to entry of WDFPF events. Necessary contact information follows:
JUDITH
M. GEDNEY PHONE:
309-837-2111
27
ELMO DRIVE
MACOMB,
ILLINOIS E-Mail
address: jm-gedne@wiu.edu OR gedney@logonix.net.
61455
U.S.A.
Application information requested: Today’s Date: __________________
Month - Day -
Year
________________________________________________ ________________________________
(Name of National
organization) Formation
Date of National Organization
Complete mailing
information of National Organization Office:
__________________________________________________. __________ Approximate number of
current
membership including, referees,
__________________________________________________, administrators, athletes and
coaches.
__________________________________________________.
_________________________________________________.
As a national
organization representing the philosophy of drug-free training and competition
within the sport of
powerlifting, we
the ____________________________________________ representing the Nation of
(Name of national organization applying for
membership)
__________________,
do hereby apply for membership into the WORLD DRUG-FREE POEWRLIFTING
FEDERATION,
Inc. As officers/administrators of our
national organization, we bind ourselves and the national organization named
above, to assure that all the requirements and regulations as set forth by the
Constitution and Rulebook of the WORLD DRUG-FREE POWERLIFTING FEERATION, Inc.
are respected and fulfilled.
We agree as a
condition for membership to pay the required annual W.D.F.P.F. membership dues,
to validate our national organization’s membership of both athletes and
officials via a photo-copy of our membership and to abide by all the rules and
regulations of the W.D.F.P.F. as set forth in the W.D.F.P.F. Constitution and
Rulebook.
We further
understand that as a member of the W.D.F.P.F. we have the privilege of being
represented by three (3) voting members in the W.D.F.P.F. annual business
meeting; the W.D.F.P.F. Congress. We
have selected our three voting members, one of which has been designated as our
International Liaison.
_____________________________________________ ____________________
(Signature of National Organization
President) (Date of signing)
Page 2, WDFPF Annual Membership Application Form continued:
NAMES and CONTACT Information of
NATIONAL ORGANIZATION’S
OFFICERS/ADMINISTRATORS:
______________________________________ ________________________ _______________________
(Print clearly: President’s name) (Complete
home phone number) (Complete
Fax number)
Complete POSTAL
ADDRESS as appears on Envelope: ___________________________
(Complete work phone number)
_____________________________________________
__________________________
_________________________________________________ (Best time to phone)
____________________________________________ ___________________________________
(Print clearly complete E-Mail address)
___________________________________________
Circle
Responsibility: INTERNATIONAL LIAISON and/or VOTING
REPRESENTATIVE for your Nation.
______________________________________ ________________________ _______________________
(Print name clearly; Vice President) (Complete
home phone number) (Complete
Fax number)
Complete POSTAL
ADDRESS as appears on Envelope: ___________________________
(Complete work phone number)
_____________________________________________
__________________________
_________________________________________________ (Best time to phone)
____________________________________________ ___________________________________
(Print clearly complete E-Mail address)
___________________________________________
Circle
Responsibility: INTERNATIONAL LIAISON and/or VOTING
REPRESENTATIVE for your Nation.
______________________________________ ________________________ _______________________
(Print name clearly; Treasurer) (Complete
home phone number) (Complete
Fax number)
Complete POSTAL
ADDRESS as appears on Envelope: ___________________________
(Complete work phone number)
_____________________________________________
__________________________
_________________________________________________ (Best time to phone)
____________________________________________ ___________________________________
(Print clearly complete E-Mail address)
___________________________________________
Circle
Responsibility: INTERNATIONAL LIAISON and/or VOTING
REPRESENTATIVE for your Nation.
______________________________________ ________________________ _______________________
(Print name clearly; Secretary) (Complete
home phone number) (Complete
Fax number)
Complete POSTAL
ADDRESS as appears on Envelope: ___________________________
(Complete work phone number)
_____________________________________________
__________________________
_________________________________________________ (Best time to phone)
____________________________________________ ___________________________________
(Print clearly complete E-Mail address)
_________________________________________________
Circle Responsibility: INTERNATIONAL LIAISON and/or VOTING REPRESENTATIVE for your Nation.