Black Country BeActive Partnership Inspired Coaches Application Form

Transcription

1 Black Cuntry BeActive Partnership Inspired Caches Applicatin Frm Guidance Ntes Please visit fr guidance n Funding aims Wh can apply? Hw are applicatins assessed? Payment (Payment nly made by BACS transfer) Resurces Cnditins f Funding Fllwing Cnfirmatin f Successful Applicatin Successful applicants will be requested t fulfil the fllwing requirements: Every cach that receives funding must cmplete 1 hur vluntary caching fr every 10 f funding received. Attend an Inspired Caches wrkshp that will be held fllwing ntificatin f successful award (please see sectin belw fr dates f these wrkshps) Register and lg hurs cmpleted in respect f the fund n cachweb Evidence qualificatin cpy f r cnfirmatin frm NGB fficer. in reprting figures n reprting template prvided t laura_whitehead@blackcuntrycnsrtium.c.uk Funding applicatin deadlines and Assessment Runds Rund 4 Fr curses and qualificatins frm 15 th Nvember 2014 nwards Opens Friday 22 nd May 2015 Clses Wednesday 1 st July 2015 Assessment Grup Week beginning 13 th July 2015 Applicants infrmed by Wednesday 22 nd July 2015 Inspired Caches Wrkshp Thursday 30 th July 2015 Please nte all successful applicants must attend this wrkshp.

2 Applicatin Frm SECTION 1 PERSONAL DETAILS (f applicant that will be attending the curse) Title Name Pst Cde Gender Male Female Date f Birth Hme N. Mbile N. D yu hld any ther caching qualificatins Tshirt Size Small Medium Large X-Large SECTION 2 - COURSE DETAILS Curse Title Level f Qualificatin Level 1 Level 2 Level 3 Curse Dates Frm T Apprx. duratin f curse in hurs Curse Venue Curse Cst Will yu be receiving additinal funding fr the curse N Yes If yes wh fr e.g. LA, NGB etc Curse Organiser

3 SECTION 3 - CLUB S DETAILS (Must NOT be the applicant attending the curse) These details are required s that we can verify yur invlvement with the club / rganisatin. Please prvide a cntact, this shuld preferably be a member f the senir management team within the club / rganisatin Club Name Pstcde Club BACS Details ClubMark (r equivalent) Accredited Number f members currently at the club Number f new participants aiming t recruit Has the club accessed funding in the last 12 mnths D yu have any plans t access funding ver the next 12 mnths i.e. small grants, facilities funding? Are yu in cntact with yur Natinal Gverning Bdy Officer Title N Yes Wrking Twards Name Psitin Within Club Hme N. Mbile N.

4 SECTION 4 - FURTHER INFORMATION (Written by the applicant attending the curse) What age grup will yu be wrking with in yur rle as cach? In what setting will yu be caching? Club After Schl Club Schl Wrkplace Cmmunity Organisatin Charitable Organisatin Other (Please Specify) Amunt f sessins/time yu will be delivering each week. Disabled Participants 1-2 hurs 2-4 hurs 4-6 hurs 6-8 hurs 8+ hurs Sectin 5 - REASON FOR APPLICATION (Written by the applicant attending the curse) Please state clearly and demnstrate the belw pints: Hw will the Club Benefit frm the funding Hw will the participants benefit frm the funding What will the increased wrkfrce/qualificatin f the wrkfrce enable yur club t d Any ther pints that will supprt yur applicatin

5 Step-by-Step applicatin prcess Submit attached applicatin frm The Black Cuntry BeActive Partnership bard asses applicatins Successful applicants club infrmed by Successful applicant t: Attend Inspired Caches Wrkshp Cmplete Caching Qualificatin Cmplete & recrd respective caching hurs Funding is paid t the club Please tick t cnfirm yu have read the cach bursary guidance ntes n the BeActive website Applicant t cmplete I hereby make this applicatin fr a Bursary fr the curse detailed abve and agree t the cnditins set ut. Signed Print Name Date Club / Organisatin t cmplete On behalf f the abve mentined club I supprt this applicatin and grant permissin fr a bursary t be paid t the club n successful cmpletin f the curse and caching hurs. Signed Print Name Date Please the cmpleted frm t: laura_whitehead@blackcuntrycnsrtium.c.uk r pst t Laura Whitehead Black Cuntry Cnsrtium Ltd The Deckhuse Waterfrnt West Dudley Rad Brierley Hill DY5 1LW Fr supprt with cmpleting this applicatin frm r questins regarding cach educatin please cntact The Black Cuntry BeActive Partnership Office n