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CNW Sponsors

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Club Northwest / Brooks Sponsorship Criteria Questionnaire
Please fill in all of the requested information.

Name		Sex Age

Address		State ZIP

City

Phone (home)		Phone(cell)

E-mail		Occupation

2006 USA Track Field membership Number
Are you a current member of Club Northwest?		Yes No
Are you currently sponsored by another shoe company?		Yes No
Are you interested in being part of the CNW / Brooks Contract?		Yes No
If yes, would you prefer contract with Brooks shoes and apparel, or apparel only?		Shoes and apparel package	Apparel only
Are you currently being treated for any physical injury?		Yes No
If yes explain briefly:
Check all broad event areas thet you currently compete in:
Track events 800m and over		Track events under 800m , including hurdles
Field events or combined events		Race Walking
Road running		Ultra running
Cross Country		Trail and mountain running

Best Marks
	Event	Mark
2006
2005
2004
2003
2002
All time Best
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