APPENDIX 4 TO

ANNEX A TO

ASCB ASL DIN

Army Sports Lottery Grant Application – WSA (Winter 2017/18)
Rank & Name / .
www.armysportslottery.com
Address
(Include Post Code/BFPO No)
Email Address
Contact Number / Date

Applications must be fully completed and submitted to the ASL office retrospectivly, please ensure that a PXR is attached, no later than 1 June annually. It is the applicant’s responsibility to ensure that all individuals listed are members of the ASL prior to the event proceeding. Applications must be signed by relevant parties. Applications submitted electronically must state:

“Certified Original Signed – Relevant Name” in the signature boxes

Return application to: Army Sports Lottery, Fox Lines, Queen’s Avenue, Aldershot, Hampshire, GU112LB or

BACS Payment Details
(Unit Central Bank Account Details) / Account Name / Account Number / Sort Code
Cheque Payment Details
(Unit Central Bank Account Details)
Grant Requested (£)
(See DIN for further information)
Start Date
/
Finish Date
Discipline / No / Summary of Activity (Exercise Name & Dates)
Alpine Skiing(12)
Snowboard (12)
Biathlon/Nordic (8)
Telemark (6)
Bobsleigh (10)
Skeleton (8)
Luge (8)
Cresta (6)
Max number allowed to be taken in brackets above


======For Army Sports Lottery Use Only ======

Nominal Roll Numbers / Lottery Members
Total Number of Tickets / Requested Funding
ASL Reference Number / AWS17/18 / Maximum Funding
Other Information
Ser /
Regt Number /
Rank /
Name / ASL Use Only
Ticket Numbers / Ser /
Regt Number /
Rank /
Name /
ASL Use Only
Ticket Numbers
1 /
19
2 /
20
3 /
21
4 /
22
5 /
23
6 /
24
7 /
25
8 /
26
9 /
27
10 /
28
11 /
29
12 /
30
13 /
31
14 /
32
15 /
33
16 /
34
17 /
35
18 /
36

======For Army Sports Lottery Use Only ======

Pro Rata Winter Sports Activity Calculator
Tickets /
Total Athlete Numbers /
Funding /
Total Funding /
Remarks
1 /
@ £25.00 /
£
2 /
@ £50.00 /
£
3 /
@ £75.00 /
£
4 /
@ £100.00 /
£
5 /
@ £125.00 /
£
Total /
£

======For Army Sports Lottery Use Only ======

Activity/Event Declaration
  • I confirm that the attached Nominal Roll is accurate and a true reflection of those who participated.
  • I confirm that this activity is not Adventurous Training, does not form part of the JSAT Scheme, and is not supported by a JSATFA.
  • I confirm that ASL funding will only be distributed to those who are confirmed as ASL Members on a pro rata basis.
  • A Post Exercise Report (PXR) is attached to this application.
    (A Winter Sports PXR Template is available from our website)

Exercise Officer Commanding Signature
Date /
Signature (Must Be Signed) / Print:
Appointment:
Commanding Officer (The organising officer cannot self-certify this application)
I approve this authorised WSA and confirm that it fulfils the criteria laid down in accordance with Army Sports Lottery.
Date /
Signature (Must Be Signed) / Print:
Appointment:

Note: Applications submitted electronically must state: “Certified Original Signed – Relevant Name” in the signature boxes above.