Application for Sportrec Sports Bursary/Scholarship 2006/07
Formal Application for Sport & Wellbeing Sports Bursary/Scholarship 2017/18
Please complete all parts of this application form, in CAPITALS and return toChris Szedlak at the address shown at the end of this form. The application also requires two completed references to be sent with the application. One which must be a sporting reference preferably from your National Governing Body or if not from your coach highlighting their support in your application and your ability to balance academic and sporting demands as well as highlighting the level you compete at.
Title / Mr/ Mrs/ Miss/ Other ………………………Surname
First Names
Date of birth
Address for correspondence (term time) / Address for correspondence (non-term time)
Tel: / Tel:
University of SouthamptonEmail: / Email:
Course
Director of Studies / Name: Email:
Faculty/Department
Level / Undergraduate/ Postgraduate/ Other………………
Method / Part-time/ Full-time
Course start date (month & year)
Expected course end date:
Status (delete as appropriate) / Current student – ID Number
Accepted onto course (not yet attending UoS)
Awaiting result of application onto course
Sport & Discipline (give details of your MAIN focus sport)
Outline your sporting success to date including level of?
Applicant must provide evidence from coach or NGB / International (i.e. representing England/Wales/Scotland/GB etc)
National (i.e. English/GB Championship, premiership league standard etc)
Regional & County (Regional Championships, CountyChampionships)
Professional/ Semi Professional Club
Outline your current training regime, both sport specific and conditioning:
What goals and aims do you have for your sport and what are you concentrating on for the coming year?
How do you feelbeingin receipt of the Bursary will assist you?
Please provide details of any competitions or events throughout 2016/17
Name/s of any University sports club/s you will continue to represent or support during your time at UoS
How did you hear about us?
Coaches Contact Details
Sporting Miscellaneous
Details of any coaching/officiating qualifications, additional interests, etc.Estimate of costs
Do you currently receive funding from your NGB? / £Estimate of cost of your sport to you last year / £
Estimate of cost of your sport to you this coming year / £
Testimonials
Personal Testimonial (Character Reference) / Sporting Testimonial (Sporting Reference)Title / Title
Name / Name
Address / Address
Tel:
E-Mail: / Tel:
E-Mail:
How they know you / How they know you
How did you originally hear about the scheme?
Signature of Applicant / Date
FOR OFFICIAL USE ONLY
Date Received / Decision / Date NotifiedSupport / Defer / Refuse
Please make sure your application contains :
Application Form
2 Completed References (these can be sent later but please make sure these arrive ASAP)
A Sporting CV highlighting your sporting career and achievements
Use additional sheets if required
Please return your completed application to:Chris Szedlak, Sport andWellbeing,Student Services, University of Southampton, Wide Lane Sports Grounds,Wide Lane, Southampton,SO50 5PE) or email (we will acknowledge receipt of all emails received)
Bursary Kit
Size ChartSize / Chest / Waist / Full Trouser Length / Women's Cut Products Only
XXS / 6
XS / 8
S / Up to 34" / Up to 28" / Up to 41" / 10
M / Up to 37" / Up to 31" / Up to 42" / 12
L / Up to 40" / Up to 34" / Up to 43" / 14
XL / Up to 43" / Up to 37" / Up to 44" / 16
XXL / Up to 46" / Up to 40" / Up to 45.5" / 18
XXXL / Up to 46" / Up to 40" / Up to 47"
If your application is successful, you will receive the following Sports Bursary Kit. Please choose your size from the options below (see Size Guide at bottom of form).
XXS / XS / S / M / L / XL / XXLHoody / / / / / / /
Tracksuit Bottom / / / / / / /
Training Shorts / / / / / / /
Training T-Shirt / / / / / / /
Athlete Profile
Name:Age:
Course:
Sport/Discipline:
Greatest Sporting Achievement:
Ultimate Sporting Aim:
Favourite Food:
Sporting Hero:
Motto or quote that you live by:
Please provide a profile photo