GlosGirlsCan: Female Coaching Bursary

Application Form

Applications open 9am Friday 1stSeptember & closes at 9pm on Sunday 1st October 2017

Section 1: About You

First Name / Surname
Do you have a disability? / YES / NO / If yes, please detail: / Date of Birth
Email Address / T-shirt size
(Unisex: XS, S, M, L, XL, XXL)
Home Tel. No / Mobile Tel. No
Home Address
Twitter account / Instagram account
Ethnic Background
A: White / British / B: Mixed / White and Black Caribbean
Irish / White and Black African
Any other White background / White and Asian
Any other mixed background
C: Asian or Asian British / Indian / D: Black or Black British / Caribbean
Pakistani / African
Bangladeshi / Any other Black background
Any other Asian background
E: Chinese or other ethnic group / Chinese / F: Not Stated / Not Stated – please write below
Any other

Section 2: Your Coaching/Leading

  1. What sport or activity do you coach/leador would like to coach/lead following this qualification?

  1. Do you currently hold any coaching, leading or activating qualifications? If so, please detail these.

  1. How long have you been coaching/leading for?

Never / 1 month – 1 year / 1 – 5 years / 5 Years +
  1. If applicable, who and where do you currently deliver? Please detail as much as possible; location, age, gender, disability, standard, ethnic backgrounds, club/group name.

Section 3: The Qualification/Award/Training/Workshop

  1. What qualification/award/training/workshop are you looking to complete?

  1. When is the course or workshop running? Please provide start & completion date if possible

  1. What is the total cost of this qualification/award/training/workshop?

  1. Are there any prerequisites to complete this course? If so, what are they? (e.g. Level 1 Qualification, DBS, First Aid)

Section 4: Your future as a coach/leader

  1. Why do you enjoy coaching/leading & what made you want to become a coach, leader, or activator? (max. 200 words)

  1. How will this qualification/award/workshop/training benefit you as a coach/leader?(max. 200 words)

  1. How will this impact upon Active Gloucestershire’s mission to get everyone in Gloucestershire active every day ? (max. 200 words)

  1. If you are already a qualified coach & are applying for a Level 2 qualification or above, we encourage you to set up a new session or activity within your club or community. If this is the case, please provide a brief description of this new session or activity (max. 200 words).

Section 5: Declaration

Please tick the boxes below to confirm the following should your application be successful.

You are female
You are aged 14+(or the minimum age to complete your chosen qualification)
You can pay for the course up front
You are a Gloucestershire resident or will be delivering activity within Gloucestershire
You will attend complete the qualification within 1 year of submitting the application
You will provide evidence of your qualification on completion

Signature:

Name:

Date:

FOR OFFICE USE, ONLY

Application Accepted
Application Declined
Reason for Decline
(if applicable)
Declaration
Active Gloucestershire Employee
Signature
Date