Application for a Scholarship for Sport (2012/13)
Please complete this Application Form clearly using black ink.
- Personal Details
Name:
Date of Birth:
Nationality:
Home Address:
Home telephone number:
Mobile telephone number:
E-mail Address:
Term Time Address (if applicable):
- Academic details
Are you currently? (Please tick) 1st, 2nd, 3rd, 4th year or Post Grad
Student Number (if applicable):
UCAS Number (if applicable):
University Course:
University Department:
- Sporting details
Your main sport:
Event/Discipline/Position:
Ranking (if applicable):
Main club:
Main Coach:
Please outline your major achievements in sport (please detail age level, year and event). Please continue on a separate sheet if necessary.
Are you committed to representing Team Leicester on a regular basis?
Are you in any national performance, development or training squads for your sport? Please specify level and dates
Are you receiving any National funding (World Class Performance, Development, BOA vouchers, TASS)? Please specify amount and period of prevision
- Supporting statement
Please complete a Personal Statement of no more than 1,000 words explaining how you would benefit from receiving a Scholarship for Sport (include references to specialist services & financial support and how they would influence your long and short term goals.
Please obtain a Reference of no more than 1,000 words from a suitable adult e.g. a teacher at your school, a coach, the National Governing Body (NGB) of the sport in which you play, explaining why you are suitable to be awarded a Scholarship for Sport.
Applications will open on the 1st June and close on July 6th 2012. Late or incomplete applications will not be considered.
Please submit this form to: Mr M Weir, Assistant Director of Sports (Sports Development),
The Sportshall,
40 Manor Road,
Oadby,
Leicester, LE2 2LL
Applications must be received before 5pm on Friday 6th July 2012. Late or incomplete applications will not be considered.
Remember to include your Personal Statement and Reference!