Application Form for a Don Oliver Scholarship

or Training Grant
Please note this form can be downloaded from
www.sportwaitakere.co.nz

To be eligible you must fulfill the following criteria:

1. Applicants must live in West Auckland

2. Applicants must be aged between 14 and 21 years
3. Applicants must be pre-elite

Applications must be received by the foundation before 30 June 2010

Name: ……………………………………………………………………............................
Address: ……………………………………………………………………………………
Phone: ………………………….. Date of Birth: ………………………………………
Email Address: ……………………………………………………………………………..
Sport: …………………………… Club: .……………………………………………….
Coach: ………………………….. Contact phone: ……………………………………..
National Association: ………………………………………………………………………
Current New Zealand ranking: ………………… Age group: ………Junior/Senior
Are you a carded athlete?: ……………………….. Carded level: …………………….
Occupation/employer/school: ……………………………………………
Parents’/guardians’ names:…………………………………………………
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Achievements (Past 3 years)
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What is your greatest sporting achievement?
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Short-term goals:
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Long term goals:
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Mentors: …………………………… Inspiring person: …………………………...

Names of current sponsors

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Sponsorship Cash: $..................... Product value: $………………....
Prize money received (past 12 months) $..............................................................................
Likely prize money amount (next 12 months): $…………………………………………...

What assistance has been provided from your national body or club?
(coaching/finance/equipment/other). This will not affect your application:
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Reason for requesting scholarship, actual costs. How fund will be used and over what
period of time (you may use a separate page for this detail):
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It is a condition of a Don Oliver Scholarship that recipients provide written reports
quarterly (1 Nov 2010, 1 Feb 2011, 1 May 2011 and 1 August 2011) and informal reports
monthly, on how funding has been used, relevant activities undertaken and achievements.
The following are also requirements:
(1) You continue to train and compete regularly to the best of your abilities under the
guidance of a recognised coach.
(2) You attend 75% of any athlete development workshops, functions or programmes
(if any) provided by or on behalf of DOYSF over the next 12 months.
(3) You take part in media and/or promotional activities as required.
(4) You acknowledge and promote the DOYSF at any opportunity in interviews and
speeches.
(5) You undertake personal appearances or events, within reason*, if requested by
DOYSF.
(* Not to conflict with training, study or to incur expense)

DOYSF reserves the right to withhold athlete payments under the following
circumstances:

 You do not supply written progress reports as required or requested by the

DOYSF Board
 You attend less than 75% of scheduled development workshops functions or
programmes (if any) without good reason
 You do not remain in contact with both the DOYSF Board and Sport Waitakere
 You take part in gross misconduct or bring sport into disrepute
 You do not undertake reasonable personal appearances when requested

In signing this form you agree to abide by these conditions.

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Signature of Applicant Date
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TO BE COMPLETED BY A REGIONAL SPORTS ORGANISATION, CLUB OR
COACH

I ……………………………… of ………………………………. declare the above

(Name) (Code/Designation)
Scholarship application is a true and correct record of the applicant’s achievements.

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Signature Contact ph day / night

Please attach one reference from coach, trainer, school principal or respected community
member.
Please return this form to:
The Administrator
Don Oliver Youth Scholarships
C/- Sport Waitakere
PO Box 21-241
Henderson
Waitakere City