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1 Nurturing Excellence Programme For Sport Application Form Please complete this form in BLOCK CAPITALS and in black ink. Once completed, please return this form, together with the appropriate documentation to: North Ayrshire Council, Community Development Team Nurturing Excellence Programme - Sport Economy & Communities 2 nd Floor, Cunninghame House IRVINE, KA12 8EE Enquiries call: Reference: Name of Applicant: Date Received: Office use only Sport:

2 Marking Criteria Terms & Conditions of Award Who can apply? Notes of Guidance The Nurturing Excellence Programme is a partnership initiative which is endorsed by sportscotland involving North Ayrshire Council, KA Leisure, Maximum Potential Sport Conditioning Centre, Stevenston and the National Sports Training Centre Inverclyde. The programme aims to compliment existing training programmes with a range of specific benefits to assist athletes achieve their full sporting potential. Athletes joining the Nurturing Excellence Programme will be able to demonstrate high levels of sporting performance and achievement or demonstrate potential and commitment to achieve success in their chosen sporting discipline. Athletes will be representing their sport at Regional, National or International levels and be committed to improving their overall performance. The programme is open to all non-professional athletes who are: 1. Resident in North Ayrshire or studying at a Further or Higher Education institution and have a permanent address in North Ayrshire. 2. Aged 11 to 23 at the time of application. 3. Participate in a sport with a recognised National Governing Body (NGB) by sportscotland or equivalent. If you are successful you agree to: 1. To be available for a maximum of 4 public appearances if required across North Ayrshire. These might include - awards evenings, launches or events. 2. To provide information for marketing when requested for the promotion of the scheme and yourself. This information will only be requested by the partnership (North Ayrshire Council or KA Leisure staff, Maximum Potential Sports Conditioning Centre and the National Sports Training Centre Inverclyde). 3. In the event of winning a medal at national championship or events, or where support is discussed during a press engagement, you agree to reference support from the North Ayrshire partners (North Ayrshire Council, KA Leisure, Maximum Potential Sports Conditioning Centre and the National Sports Training Centre Inverclyde). 4. Within a year of an award copies of receipts and other methods of proof of expenditure will be required by the Council, together with a Financial Monitoring Report on spending. 5. The award shall not be used for purposes other than those detailed in the application. 6. Individuals may not dispose of any equipment purchased in full or part using the award without the prior agreement of the Nurturing Excellence Programme. 7. If an individual has received an award and is no longer participating in that sport, then any equipment purchased from that grant will revert to the Nurturing Excellence Programme (Council). 8. If the costs incurred are less than the amount approved, the remainder of the award must be returned to the Council unless otherwise agreed. 9. Individuals should ensure they are appropriately insured for equipment requested. 10. All decisions and subsequent awards are at the discretion of the Nurturing Excellence Reference Group consisting of: North Ayrshire Council s Community Development Manager, sportscotland and partner agencies. Each athlete will be marked equitably against the following elements: 1. Regional in the previous 12 months, top 3 finisher in County championship events, or selected for a County/West Development Squad; National in the previous 12 months, finalist at National age group championships, or a top 10 ranking in your chosen sport, or invited to join a National Development Squad by the National Governing Body; International in the previous 12 months, must have represented Scotland or Team GB at an International competition/championship event. 2. You must be aged 11 years to 23 years. 3. You must be a North Ayrshire resident. 4. Additional information given in athlete profile and your justification for joining the scheme (validity, quality and commitment to the scheme). 5. Participation in the programme and events during the previous 12 months. 6. Gold Award Athletes may be required to attend a short meeting with NEPS Reference group to discuss their ambitions and aspirations. This will be included in the assessment of the Award. 2

3 Nurturing Excellence Programme - Sport Application Form To apply for the Nurturing Excellence Programme, you must be resident in North Ayrshire or studying at a Further Education institution and have a permanent address in North Ayrshire. Please complete each section fully and include the relevant documents with your application. Section 1 General Information Applicant s Name: Applicant Address: Town: Telephone Number: Address: Date of Birth: Sport: (including discipline) Age Group: Name of Club: Name of Coach: NGB/National Squad Coach Contact Details: Tel No: School: Post Code: Mobile No: Mobile No: Coach Supporting Statement: (please provide relevant information that supports your athlete s application) Signature of Coach: Date: Do you have sponsorship? (please tick) Yes No Amount of Sponsorship: If yes, who? Why should we choose you? (Please only use the box provided) What will you bring to the Nurturing Excellence Programme? (Please only use the box provided) What will the award be used for? 3

4 Attach photo here Section 2 Athlete Profile Form Information in Support of Application: Name: Sport: Biography: Favourite quote: Who is your biggest influence? What is your proudest moment? What is your tip for anyone wanting to take part in sport? What is the best piece of advice you have been given? Achievements in last 12 months: Sporting aims for the future: 4

5 Facility Access Level & Option Choice Financial Support Optional Support Services Who is eligible? Section 3 Level & Option Choice Award Levels Bronze Silver Gold Athletes competing at or selected for participation at District/Regional level. Option (a) The KA Leisure Offer Up to two sessions per week over a 12 month period: Court space for individual sports Sport specific conditioning training Or a combination of the two OR Athletes competing at a National level in teams or individual events. Athletes representing Scotland or Team GB in International competitions. Option (b) The Maximum Potential Sports Conditioning Programme Offer: A full 12 month, twice weekly, supported athlete development programme including: Professionally coached strength and conditioning. Speed and agility coaching. Olympic lifting for sport. Athlete nutritional support. Tri-annual sports testing (including Functional Movement Screen) OR These offers will end on 31 March 2016 Option (c) The National Sports Training Centre Inverclyde Offer: Unlimited access to Xcel Fitness suite for athlete and attending coach Sport specific conditioning training Technical and programme support available upon request Court space available for individual training Bronze Silver Gold These amounts will be payable after you successfully attend your chosen option for 8 sessions. Athletes are required to provide evidence of their attendance in support of the above requirement. Please tick one box only: (please refer to the Who is eligible? section above) If you do not wish any of the support service options (as described above) then please choose Level Award only. Bronze Level Award: Plus (a) Plus (b) Plus (c) Bronze Level Award only Silver Level Award: Plus (a) Plus (b) Plus (c) Silver Level Award only Gold Level Award: Plus (a) Plus (b) Plus (c) Gold Level Award only Further detailed information on KA Leisure, Maximum Potential Conditioning Centre or National Sports Training Centre Inverclyde will be available from the providers upon request. All athletes will receive a KA Leisure Multi Use Membership up until 31 March This provides unlimited access to all Leisure Facilities which includes free access to: Fitness Studios and Fitness Classes Ice Rink (public skating) Athletics track and field facilities Swimming Pools Golf Driving Range Children s Gym Visit the relevant websites for more information: KA Leisure: Maximum Potential Sports Conditioning Centre: National Sports Training Centre Inverclyde: 5

6 How do I apply? Section 4 Declaration & How to Apply To the best of my knowledge, the details in this application are correct. By signing this form I agree that I will abide by the terms & conditions as stated and understand information from this form may be used for administration purposes by Nurturing Excellence Programme in accordance with data protection. Please print the form and then sign below (if you have received an e-form). Name of Applicant: Signature: Date: Parental Consent (if the applicant is under 18) Parent/Guardian Signature:. Date: Print name:... Note: Cheque will be made payable to the parent/guardian if applicant is under 18 years of age. Parent s Supporting Statement: (please provide relevant information that supports your child s application) Make sure you are eligible, have read the Notes of Guidance and Terms & Conditions and have completed all sections. Collect copies of evidence from your National Governing Body to prove your performance level such as: Results from your NGB s website Letters of invitation to the national or international team Letters of support from your NGB Press releases and media about your achievements. It is important that you ensure that your Coach completes the section providing a supporting statement and coaching requirements and that you complete the Athlete Profile form, as these add to your application form. Complete all sections of the application form and return to: Community Development Team NEPS Economy & Communities, 2 nd Floor Cunninghame House, Irvine. KA12 8EE All of the information on this form is confidential and will only be viewed by the Nurturing Excellence Reference Group if required for the purpose of assessing awards. It will be held for a period of 12 months from date of award and details will not be passed onto any other agency without your prior consent. Following the Public Pound All funding of individuals by North Ayrshire Council is governed by the Council s Code of Practice for Funding of individuals which can be read on the Council s website: This includes standard Conditions of Awards which apply to all Council awards/grants, including those within this scheme and provide more detail than contained here. These should be read by individuals applying for funding. 6