Coaching Bursary Application Form - Phase 2

Coaching Bursary Application Form

This is the application form for the SkillsActive London Coaching Bursary which is being co-financed by the Learning and Skills Council in London and the Sport England London Region. You will hopefully have been directed to this page by a representative from your coaching/sporting environment, your National Governing Body of Sport, another coaching project in London (e.g. Coachability, SPRINT, Women Into Coaching), or through your Pro Active Partnership in London. Please note, not all applications will be successful - an endorsement from any of the organisations outlined above and someone who manages your coaching time in the sporting environment will help to ensure your application is successful.

If you have any questions about the scheme, please do not hesitate to contact somebody from your Pro Active Partnership, or alternatively Miriam Farley or Steve Mitchell on coaching@skillsactive.com or 020 7632 2000. Good Luck

Please note that due to high levels of demand, we are only taking applications for current UKCC endorsed i.e. athletics, badminton, basketball, cricket, cycling, equestrian, football, golf, gymnastics, hockey, judo, netball, rugby league, rugby union, rowing, swimming, squash, table tennis, tennis, triathlon and orienteering.

A reference will be required as part of this application

Your Personal Details

	Please complete your details below:
	Title:
	First name:
	Surname:
	Address 1:
	Address 2:
	Town:
	County:
	Postcode:
	Telephone number:
	Mobile number:
	Personal email:

Your Personal Details

Gender:
Please ü one only

Male

Female

Age (optional)

Ethnic background:
Please ü one only

White

Asian/Asian British

Mixed ethnic background

Black/Black British

Chinese

Other ethnic background (please specify below)

Your Personal Details

Do you consider yourself to have a disability / impairment?
Please ü one only

Yes

Don't know

Your Current Qualifications and Experience

	Which of the following qualifications (if any) have you already achieved? Please ü as many as apply
		Have achieved
	NGB Level 1 Qualification
	NGB Level 2 Qualification
	NGB Level 3 Qualification
	* New NGB UKCC Level 1 Qualification
	* New NGB UKCC Level 2 Qualification
	* New NGB UKCC Level 3 Qualification
	Level 2 NVQ in Coaching, Teaching and Instructing
	Level 3 NVQ in Coaching, Teaching and Instructing
	Level 2 NVQ in Activity Leadership
	Level 2 NVQ in Instructing Exercise and Fitness
	Level 3 NVQ in Advanced Fitness Instructor
	Other (Coaching Related)

Your Current Qualifications and Experience

Outside of your work in coaching, do you hold any other qualifications at Level 2 or above? (e.g. 5 GCSE grade A-C, A levels, Level 2/3 NVQ, HND, Foundation Degree, BA Honours, PHd, MSc)
Please ü one only

Yes

Don't know

	Please provide details of the highest level of qualifications held: Please write in below

Is your highest level qualification (non-coaching) in a sport/fitness related subject?

Yes

Don't Know