YES NO Are you an Athlete with a Disability? If Yes, what is your classification? Who is your National High Performance Director? HPD Name: Your National High Performance Director (HPD) will be contacted HPD HPD Email: Who is your current coach? Your coach may be contacted Coaches Name: Accreditation Level: Coaches Phone: Coaches Email: List your best 3 International Competition results below: (from the previous 12 months) Time/ Date Competition name/venue Place Event/Discipline Points/ dd/mm/yy Score Event Example FINA World Championships, Barcelona, YES 15th 100m Backstroke 1/12/15 Spain YES YES YES *The highest ranked event specific to your sport at the appropriate age and level i.e. World Championships List your best 3 National Competition results below: (from the previous 12 months) Date Time/ Points/ Competition Place Event/Discipline dd/mm/yy Score Example National Championships Sydney 4th Men’s 105kg + 314kg 2/3/16 Do you have an Individual Performance Plan? YES NO What is your estimated expenditure and revenue during the next 12 months Includes Type Cost Coaching fees, equipment, competition expenses, travel, etc Expenditure $ Professional player payments, DAIS, grants, competition earnings, Revenue $ sponsorships, etc How many hours do you train per week? 0-5 5-10 10-15 15-20 20+
Are you an Athlete with a Disability? If Yes, what is your classification? YES NO Your National High Performance Director (HPD) will be contacted Who is your National High Performance Director? HPD Name: HPD HPD Email: Your coach may be contacted Who is your current coach? Coaches Name: Accreditation Level: Coaches Phone: Coaches Email: List your best 3 International Competition results below: (from the previous 12 months) Date dd/mm/yy Competition name/venue Place Event/Discipline Time/ Points/ Score Event Example 1/12/15 FINA World Championships, Barcelona, Spain 15th 100m Backstroke YES YES YES YES *The highest ranked event specific to your sport at the appropriate age and level i.e. World Championships List your best 3 National Competition results below: (from the previous 12 months) Date dd/mm/yy Competition Place Event/Discipline Time/ Points/ Score Example 2/3/16 National Championships Sydney 4th Men’s 105kg + 314kg Do you have an Individual Performance Plan? YES NO What is your estimated expenditure and revenue during the next 12 months Includes Type Cost Coaching fees, equipment, competition expenses, travel, etc Expenditure $ Professional player payments, DAIS, grants, competition earnings, sponsorships, etc Revenue $ How many hours do you train per week? 0-5 5-10 10-15 15-20 20+
SASI_Application_Form_Individual_Athlete_Scholarship_2018.docx