Apply — Great Southern Academy of Sport

Scholarship Application Form

Applications are open from Monday 1 April and close at 5pm on Monday 15th April 2024.

This form cannot be saved halfway through, we recommend you reading through the form to begin with, then create your long answers in another document to copy and paste once you have everything ready.

Application Form

DETAILS OF ATHLETE

Name

First Name

Last Name

Date of Birth

(Must be aged at least 13 years on at least one day during the scholarship period)

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile

(###)

###

####

Gender

Male

Female

Other

Does the applicant identify as being of Aboriginal or Torres Straight Island descent?

Yes

Shire of Residence

DETAILS OF PARENT/GUARDIAN

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Phone

(###)

###

####

Parent/Guardian Email

STATE SPORTING ASSOCIATION (SSA) INFORMATION

Sport in which you participate in or play

Name of the State Sporting Association (SSA) that is supporting your application

Name of contact person at SSA

First Name

Last Name

Position held at SSA

Email of contact person at SSA

Phone of contact person at SSA

(###)

###

####

DETAILS OF COACH

Name of Coach

First Name

Last Name

Email of Coach

ATHLETE APPLICATION DETAILS

Athlete Selection Criteria

Please provide a brief statement that demonstrates how you (the applicant) meet the GSAS selection criteria. Please write about your current achievements to show why you should be selected into GSAS (ie. the highest level of team selected into this year or individual results achieved). Please also show other sports played and anything else you feel relevant to the application. The athlete selection criteria can be viewed by copying and pasting this link to your browser – https://gsaswa.squarespace.com/eligibility

Athlete Goals

Please provide your personal goals for the scholarship period (if you are successful) and ensure you identify how you will know if you have achieved them. Use the SMART principle -Specific, Measurable, Achievable, Realistic and Time bound.

What can GSAS do to help you achieve these goals?

Tell us what you want and what you need?

Name of person completing this application

If not completed by the applicant (i.e parent / guardian)

First Name

Last Name

I confirm that the High Performance Manager or approved representative of my SSA and/or the RSA endorse and support this application

Yes

I certify that the information provided in this application is true and correct

YES