**Name:

  Street Address:

**City:   **State:             Zip:     Country:

**Phone: XXX-XXX-XXXX:       
**Email Address:

**Age:  
Sex:  Male Female

I am interested in a  Individual Semi-Custom Full Custom Consultation not sure which level plan.
I am interested in working with the following coach: (Leave blank if you are unsure or would like a recommendation)

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 - General Road Racing - Time Trialing Road Racing - Criterium Racing Mountain Bike Racing - Cross Country Mountain Bike Racing - Endurance Cyclocross Racing Triathlon (any distance) Track Racing - Endurance Track Racing - Sprint Running - Beginning Running - Marathon/Half Marathon Running - Endurance trail running Combination focus Other racing goal Choose one

Please select your current competitive categories where applicable:
Road Racing Category: Not applicable No racing license yet 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: Not applicable Cat 3/Beginner Cat 2/Sport Cat 1/Expert Pro
Cyclocross Racing Category: Not applicable No racing license yet Category 5 Category 4 Category 3 Category 2 Category 1 Non US racing category Collegiate Category C Collegiate Category B Collegiate Category A
Track Racing Category: Not applicable No racing license yet Category 5 Category 4 Category 3 Category 2 Category 1 Non US racing category Collegiate Category C Collegiate Category B Collegiate Category A
Triathlon grouping: Not applicable Beginner Competitive Age Group Elite
Run grouping: Not applicable Beginner Competitive Age Group Elite

Number of years you've competed: I have not raced yet A few races here and there Less than one year 1 year 2 years 3 years 4 years 5 years More than 5 years I used to race, but took a break for a long time Select one

For Non-Competitive Athletes:
My main interest in looking for a coach is for: Select one Century Riding Speed Century Ultra Century Multi-day Tour General Fitness Weight Loss Other non-racing goal - (Please note in the Comments Section) Not applicable
Riding or other training 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: Please select one Local club members Local coach Regional coach or Coaching Company Books Magazines Online training program w/o coach 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 Other reference Please select one

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


If you are outside of the US and would like to be contacted by Skype, please be sure to include your Skype screen name.

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