Elite athlete grant form

To support Elite Athletes and emerging athletes at Deakin University. The grants are designed to assist students with balancing the demands of elite sport and study to successfully complete their higher education at Deakin University.

Required fields are marked with an asterisk (*).

Student details (personal)

1. Title *

Mr
Mrs
Miss
Ms

2. Surname *

3. Given name(s) *

4. Residential address

5. Date of birth *

Day Month Year

6. Contact number

7. Deakin email *

8. Gender *

Female
Male
Other

9. Country of birth *

10. Nationality *

Sporting documentation

11. Please explain why you need a Deakin Elite Athlete Support Grant, to assist you as a student to complete your study? *

12. Sports resume * To assist Deakin Universities assessment process of the Elite Athlete Support Grant, please provide your sporting resume outlining::

Participation history

Major achievements

Personal bests

Future goals

Employment relating to sport (eg coaching roles, fitness, junior clinics etc).

(Attachment to be less than 5 MB)

13. Evidence of documentation * Please provide a letter from your relevant Sporting Organisation verifying your elite athlete status (Attachment to be less than 5 MB)

Type of grant

14. Select grant * Students can receive a maximum of three grants while studying at Deakin, which are only available over two consecutive years.

Elite Athlete Sports Grant
World University Games Grant / World University Championships Grant

Student details (sport)

15. Sport *

16. Home club / team *

17. Highest current level of representation *

18. Most notable sporting achievements *

19. Number years representing Deakin University If applying for the World Uni Games.

Sporting schedule

20. List the events/leagues you currently compete in? *

21. List the upcoming events you have been selected for or are targeting? *

22. List your most recent major event / league that you participated in? *

Sporting referees - please list two sporting referees (coaches, manager, teammates, etc).

23. Name *

24. Sporting relationship *

25. Contact number *

26. Name *

27. Sporting relationship *

28. Contact number *

Income from sport

29. Do you earn over $15,000 per year from sport including sponsorship: *

Student details (banking)

39. Account name *

40. BSB number *

41. Account number *

42. Financial Institution *

Applicant declaration

43. Please read carefully * By checking this box you declare that the information provided on this form is true and correct. I agree that these details may be made available to both Deakin University and DUSA, and respective selection committee personnel. I also agree to assist & participate in Deakin University related marketing activations (attendance at events, supplying images/videos for publishing, interviews, blogs etc)

I agree

Privacy collection statement:

The information on this form is collected for the primary purpose of the Elite Athlete Sports Grant program. If you choose not to complete all the questions on this form, it may not be possible for Deakin University to assist you as a talented student athlete. Personal information may also be disclosed to Deakin University faculty contacts. You have a right to access personal information that Deakin University holds about you, subject to any exceptions in relevant legislation.

For further information, please contact the Elite Sports Coordinator on 0438 712 324.