Lewisham Sports Talent Bursary 2016/17
Application Form

Please complete this form with as much detail as possible to allow us to accurately assess your application for funding. Incomplete forms will not be taken forwards to the Assessment Panel.

Contact information (please print your details below)

Your name

Who you play for (Club/Team name)

Sport

Contact phone number

Contact email address

Contact address (including postcode)

Proposed costs

Total funding requested

(Up to £500)

Breakdown of funding spend (please itemise proposed spend)

What / When / Cost
i.e. transport, physio, equipment etc / Dec ‘16 / £100
Total Costs

How does this application meet the necessary funding criteria? (Maximum 500 words)

Please refer to the Lewisham Sports Talent Bursary Fact Sheet criteria and evaluation information – the more detail you provide the more likely that your application will be successful

Are you affiliated to, or a member of a National Governing Body of Sport?

Yes What is your affiliation/membership number?

No

Please include all necessary evidence as described within the Evaluation Criteria on the Lewisham Sports Talent Bursary Fact Sheet.

(i.e. Letter of endorsement from NGB, Proof of Address etc)

Declaration

I declare that all information that I have provided in this application is true and that if successful I will abide by the awarding criteria/funding conditions as described by the funding body.

Name Date

______

Checklist

I have completed the application form fully

I have included all relevant information about how my application meets the funding criteria

I have included all necessary supporting evidence

I have kept a copy of my completed application for reference

Please return your completed application form and supporting documentation (or if you have any queries) to – by the 4 November 2016

Lewisham Sports Talent Bursary

Cultural and Community Development Service

2nd Floor Laurence House

Catford

SE6 4RU

Please note it is your responsibility to confirm that your application has been received and that incomplete application forms won't be taken forward to the judging panel.