**Name:

**Street Address:

**City:   State:     Zip:     Country:

**Phone: (area code first) XXX-YYY-ZZZZ

**Email Address:


**Age:   Male Female

I am interested in a  Individual Semi-Custom Full Custom Consultation not sure which level plan.

For Competitive Athletes: (If you are not a competitive athlete please skip to the non-competitive section below)
My main interest in looking for a coach is for: Road Racing Criterium Racing Mountain Bike Racing Cyclocross Racing Triathlon (any distance) Track Racing Ultra Endurance Racing Beginning general racing Other racing goal Choose one

Road Racing Category: Don't have a racing license Category 5 Category 4 Category 3 Category 2 Category 1 Non US racing category Collegiate Category C Collegiate Category B Collegiate Category A
Mountain Bike Racing Category: N/A Beginner Sport Expert Semi-pro Pro
Track Racing Category: N/A Category 4 Category 3 Category 2 Category 1
Number of years you've raced: I've never raced A few races here and there Less than one year 1 year 2 years 3 years 4 years 5 years More than 5 years

For Non-Competitive Athletes:
My main interest in looking for a coach is for: Century Riding Speed Century Ultra Century Multi-day Tour General Fitness Weight Loss Other non-racing goal Not applicable Choose one
Riding experience: Select one Less than one year 1-2 years 2-5 years 5-10 years More than 10 years

My main resource for training information in the past: Local club members Local coach Regional coach or Coaching Company Books Cycling magazines Training camp Other
I have approximately: Fewer than 10 hours per week to train 10-12 hours per week to train 12-15 hours per week to train More than 15 hours per week to train

How did you find out about Wenzel Coaching? A friend recommended Wenzel Coaching I linked here from a search engine I linked here from another cycling site I linked here from cyclingnews.com I linked here from a banner ad I saw a print ad in a local cycling mag or newsletter I saw an article in a cycling mag written by a Wenzel Coach I saw or received a hangtag in a partner bike shop My club is sponsored by Wenzel Coaching Please choose one

Please tell us a little about you, your goals, your training and racing experiences so far and the kind of training program you are looking for. Be sure to mention the name of any coach you may be interested in as well:

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