Athlete Development Grant Application Form Please enable JavaScript in your browser to complete this form.BC ATHLETE DEVELOPMENT GRANTPlease mail or e-mail the following: 1. A copy of last year's list of competition events that you participated in 2. A copy of this year's list of competition events that you plan to participate in 3. A resume of your results (within the last year at minimum) provided by your Coach/Trainer or yourself. 4. A copy of your Coach's certification (highest NCCP level) if you have one.A. Personal Data (to be completed by the athlete)Name *FirstLastEmail *PhoneGenderMaleFemaleDate of BirthAddressAddress Line 1Address Line 2City--- Select state --- AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonProvincePostal CodeAre you a Canadian Citizen?YesNoName of SportIs this your 2nd consecutive year as a member of BCDSF?YesNoB. Additional Information RequiredPlease provide the reasoning for the funding support. *NOTE: The funds cannot be used for any competitions. How much are you asking for? *When would you be using the funds by? *C. History of Funds ReceivedHave you received funds from BCDSF and/or other provincial organizations in the last 5 years? *YesNoHow much did you receive per year? *Have you received funds from CDSA and/or other Canadian organizations in the last 5 years? *YesNoHow much did you receive per year? *Do you currently receive other sources of funding? *YesNoWhere do you receive your funding from? *D. Your Competition HistoryPlease include the events you have participated within the last 10 years.Please indicate all events that you have participated in within the last 10 years (check all that apply).Provincial or National ChampionshipsWorld Deaf ChampionshipsPan-American Deaf GamesDeaflympicsPlease specify which year you have participated and in what city/country.Please list your top 3 past results. Please include your ranking, how many teams/participants were involved and your placing in the event.What is the highest competition level you have reached or participated in?RegionalProvincialNationalInternationalE. Training and Current Competition DataNumber of training hours per weekNumber of training weeks per yearDo you have an individualized specific training program?YesNoAre you following an annual training plan?YesNoDo you use a daily/weekly training log?YesNoFor individual athletes: What is your current level of competition?RegionalProvincialNationalInternationalFor athletes that are part of a team: Please indicate the competition level you are currently playing with? (please check all that apply)National Hearing TeamNational Deaf TeamProvincial Hearing TeamProvincial Deaf TeamIf you are a member of a National Team, please indicate the number of training camps/competitions completed for Canada to date.F. Coaching DataPlease continue with the rest of this section if you have a coach training you.Do you have a coach training you?YesNoCoach's Name *FirstLastCoach's Email *Coach's PhoneCoach's Address (City, Province)What is the highest NCCP Level they have? (if known)Please mail or e-mail a copy of certificate.Additional comments/notes regarding this coachBy pressing submit you declare that the information on this application has been filled out to the best of your knowledge and is true and complete. If verification of your information is required, you give us approval to investigate further. In return for any assistance to me under the BCDSF Athlete Development Grant, you agree to fulfil all training and competition commitments, to make yourself available to BCDSF or/and team Canada selection, and to contribute to athlete and coaching development programs run by the BCDSF. You hereby permit the unrestricted use of your name, list of sport accomplishments and BCDSF Athlete Development Grant generated images for the purpose of recognition by the BCDSF officials and the media as they pertain to the BCDSF Athlete Development Grant.Submit
