MANIAH BETHAM SQUAD SCHOLARSHIP APPLICATION FORM APPLICANTS DETAILS First Name: ______________________________________ Surname: _____________________________________ Address: _______________________________________________________________________________________ Suburb:__________________________________________________________________ Postcode:______________ Phone: (H) ______________________________________ (M)____________________________________________ Email: __________________________________________________________________________________________ SWIMMING DETAILS: (The following information has no bearing on the outcome of the application however is designed to get to know the applicant better) Squad Level Gold Silver National Development Bronze Advanced Bronze Teen Gym/Swim Bronze Fitness Development Favourite 3 events 1. 2. 3. Personal Best Times for these events 1. 2. 3. Swimming achievements to date Short Term Swimming Goals Long Term Swimming Goals APPLICATION CRITERIA: Duration as a Ripples Squad Member? Duration as a Ripples Club Member? QUESTIONNAIRE In 250 words or less for each question please outline to the panel how you meet the following essential criteria. 1. Demonstrates regular consistency with attending training sessions, is always prepared and for each session and follows directions well from the coaching staff. 2. Displays respect for the coaching team, Ripples staff, other team members and their families. 3. Promotes and supports the Ripples swim squad 4. Fosters a team spirit. 5. Comes from a disadvantaged or unique background i.e. low-social economic, large family, single parent family, from an Aboriginal or multi-cultural background etc… 6. Demonstrates diligence and dedication towards their swimming goals. 7. Creates a positive team atmosphere and is a potential role model to other squad participants. APPLICATIONS CLOSE 30TH APRIL 2015 Applications will be accepted via email to [email protected] or in person to Ripples Reception please address all applications in person in an envelope and addressed: Attention: Tania Weatherley Maniah Betham Scholarship Application ENQUIRIES If you have any additional enquiries regarding this scholarship please contact: Tania Weatherley Program Coordinator Tel: 9833 3000 Email: [email protected] Alternatively Tammy Weatherby Tel: 9833 3000 Learn to Swim Team Leader Email: [email protected]
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