NGB Satellite club Expression of Interest Form

We are currently planning our Year 3 Satellite club programme in Lincolnshire.

If you would like to apply for CSP match funding to support your NGB Satellite club or know of a club who is already linked to a secondary school or would like to work more closely with a secondary school in the area then please detail this information below.

Section 1: NGB match funded Satellite club (please only complete if applying for CSP match funding to support an NGB Satellite club)

Club:
Club Address:
Contact Name:
Phone:
E-mail address:
Website:
2. Is the club: / Accredited / YES* / NO*
Working towards / YES* / NO*
None of the above / YES* / NO*
3. Does the coach delivering the sessions hold a level 2 or higher qualification? / YES* / NO*
4. Is the coach registered with a National Governing Body? / YES* / NO*
5. Have they been DBS/CRB checked? / YES* / NO*
6. DBS/CRB Reference number:
7. Are members of the club part of the Lincolnshire Coach and Instructor Network (CIN)? (Please note you would need to be part of this free network to be eligible to run a Satellite club) More information can be found on our website http://lincolnshiresport.com/cin/
8. Does the club have a Child Protection Policy? / YES* / NO*
9. How much CSP funding would be required to support this Satellite club?
10. What would this funding be used for?

Section 2: CSP funded Satellite club (please complete if applying for CSP funding to support the full costs of a Satellite club)

1. Please list the club/s that is interested in running a Satellite club.
2. Detail how the sport/activity would meet the needs of young people.
3. Please list the school/s that the club/s would like to work with: / Does your club already have some form of link with this school?
YES* / NO*
YES* / NO*
YES* / NO*
YES* / NO*
YES* / NO*
4. Provide any evidence of the demand for this sport/activity within the schools listed above;
5. Please indicate how much funding would be required to support this Satellite club?
6. Any other information you think relevant in relation to the Satellite club?

* Please select as appropriate

Please complete and return to the Children & Young People Team at Lincolnshire Sport, Unit 9, Allenby Business Village, Crofton Road, Lincoln. LN3 4NL or email;

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