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. 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.

Your Contact Details

Please note that by completing this application form you are agreeing to be a referee for all applicants listed in this application. You will be contacted by SkillsActive/your local Pro-Active partnership to verify your position and the details contained in this form.

	Please complete your details below:
	Title:
	Name:
	Position/Job:
	Organisation:
	Address 1:
	Address 2:
	Town:
	County:
	Postcode:
	Telephone number:
	Mobile number:
	Email:

Your Organisation

	Which sub-region of London does your organisation mainly deliver coaching in?
	North London		South London		Central London
	East London		West London

	Which borough (s) of North London does your organisation deliver coaching in? Please ü as many as apply
	North - Enfield		North - Haringey
	North - Barnet		North - Waltham Forest

	Which borough (s) of East London does your organisation deliver coaching in? Please ü as many as apply
	East - Redbridge		East - Hackney		East - Bexley
	East - Havering		East - Tower Hamlets		East - Lewisham
	East - Barking and Dagenham		East - City of London
	East - Newham		East - Greenwich