Application Form - Individual Please note a parent/guardian can fill out this form on behalf of the applicant.Eligibility Criteria - Aged 12-17 years. Applicant must be turning 12-17 the calendar year of the competition. Ages are applicable for both team and individual applications. - Resident of Eden NSW locality. - Have a demonstrated talent in sport - Shows signs of progressing in chosen sport I confirm that the applicant meets all the eligibility criteria(Required) Yes No Not sure I understand that the Eden Youth Sports Foundation receives a large number of applications and the grant cannot be guaranteed.(Required) Yes No Personal Details of ApplicantYour Name(Required) First Name Surname Your Address(Required) Street Address Address Line 2 State Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Application Date of Birth (dd/mm/yyyy) you must be turning 12-17 years of age in the same calendar year as the nominated championships.(Required) DD slash MM slash YYYY Do you identify as Aboriginal and/or Torres Strait Islander?(Required) Yes No Sex(Required) Male Female Event DetailsName of the event?(Required)What organisation is running the event?(Required)When and where is the event being held?(Required)What team/organisation are you representing?(Required)How often is the event held (annually, one-off etc)(Required)What is the selection criteria to participate?(Required)What is the sport relevant to this application?(Required)Event start date(Required) DD slash MM slash YYYY Event end date(Required) DD slash MM slash YYYY Competition Level & PathwayWhat governing body sanctions the event?(Required)What pathway opportunities are available from this event?(Required)Athlete InvolvementHow did the athlete qualify or get selected?(Required)How long has the athlete been competing at this level?(Required)Preparation & CommitmentWhat training or preparation is required to compete at this event?(Required)How often does the athlete train?(Required)Impact & GoalsWhat are the athlete's goals for this event?(Required)How will attending this event benefit their development?(Required)What are their longer-term sporting aspirations?(Required)Financial & Support ContextWhat are the total costs involved in attending?(Required)Are their any barriers to participate without assistance?(Required)Assessment CriteriaWhat achievements has the applicant attained in their chosen sport?(Required)e.g. representative teams, championships, awardsHas the applicant been selected for regional, state or national squads?(Required)Please provide detailsWhat level of competition is the applicant currently playing in?(Required)What evidence is there of commitment to improving their performance?(Required)Example - training frequency, camps, clinicsHas the applicant participated in any development programs or pathways?(Required)How does the applicant demonstrate dedication, discipline and sportsmanship?(Required)Does the applicant show potential to progress to higher levels? If so, how?(Required)What makes this athlete stand out from others at a similar level?(Required)How does the applicant balance training, competition and other commitmments?(Required)In 250 words or less include any other details you feel is relevant to their application.(Required)Your answer should demonstrate the outcomes and solutions you believe the grant will help you to achieve in sportSupporting EvidenceCan you provide references or endorsements from coaches, trainers or sporting organisations?(Required)Are there any statistics, rankings, or measurable results that demonstrate performance?(Required)Confirmation of SelectionName of professional vouching for applicant(Required) First Name Surname Position(Required)for example coach, team manager, school sports coordinator)Please upload your support letter(Required) Drop files here or Select files Max. file size: 20 MB. Contact details of professional must be included in the support letterBank Details of Parent/Guardian (for payment of grant)Account Name(Required)BSB(Required)Account Number(Required)Parent/Guardian DetailsParent/Guardian Name(Required) First Name Surname Relationship to applicant(Required)Mobile Number(Required)Email(Required) Preferred Method of Contact(Required)EmailPhoneCertification, Privacy & Person InformationPersonal information submitted via the online application by the Eden Youth Sports Foundation for the purpose of considering applications and administering the grant program. The personal details of successful applicants, including: biographical information such as their name, suburb, sport, supporting organisation, and any photography or video footage of them produced in connection with the program; the value of the grant awarded; and a brief description of the purpose of the grant, may be released by the Eden Youth Sports Foundation to the public and the media, and may be placed on the Eden Youth Sports Foundation or other appropriate websites, including for promotional purposes and for the administration of the program. I, the Parent/Guardian of the applicant agree to the program guidelines(Required)YesNoUnderstand that if successful the applicant’s name and photo will be published on the Eden Youth Sports Foundation website and Facebook page.(Required)YesNoCertify that the information supplied in this application is true and correct. (Required)YesNoFinal Notes- You must now submit your application. - All questions are required to be answered. If you have missed an answer, you will be alerted when you try to submit. - If you have successfully submitted your application, you will receive an automated email with a copy of your submission. If you do not receive an email please contact tourism@esrc.com.au - Applications you have completed and saved, but not submitted, will not be considered. - All approved applications will require a Funding Acquittal to be submitted upon completion of the funded activity.
reception@esrc.com.au
02 6496 1577
