Lewisham Coaching Scheme
ApplicationForm
Before completing this form, please ensure that you have confirmation of 75% funding from the Mayors Skills Legacy Fund. Incomplete forms will result in a delay in assessment of your application. Please note that the 25% or £200 (whichever is the lesser amount) will be a re-imbursement to you for the funds that you have already paid direct to the course deliverer. As such you will also need to provide evidence that this has been paid and your course has been booked.
Personalinformation
Your name
Contact phone number
Contact email address
Contact address (including postcode)
Gender
Date of birth
Ethnic background (please tick)White/White British Asian/Asian
British Black/Black British Chinese Mixed Would prefer not to say Other
Do you consider yourself to be disabled? Yes No
If yes, which impairment group are you?
Name of organisation/club/team/school
Sport
Course details
Name of course you want to attend
Sport
Full cost of course
Name of course deliverer
Contact details for course deliverer
Volunteering Placementdetails
Name of organisation at which you will be completing your volunteer hours
Contacts name at organisation
Contacts email
Contacts phone number
Individual 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. Specifically I commit to the delivering the specified number of volunteer hours indicated by the NationalSkillsAcademy, and will track them through the ActivePassport that I will be supplied with.
Name Date
______
Checklist
I have completed the application form fully
I have enclosed evidence showing that 75% of my course costs will be covered by the Mayors Skills Legacy Fund
I have enclosed evidence that I have already paid the remaining funds to the deliverer
I have enclosed evidence showing that I am booked onto a course
I have kept a copy of my completed application for reference
Please return your completed application form (or if you have any queries) to
Lewisham Coaching Scheme
Sport and Leisure 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.