2016 Sport Partnership and Scholarships Application

This form must be completed by a representative of each State Sport Association that is applying on behalf of athletes, coaches or officials for 2016 MWAS scholarships. After completing this form, the SSA must ensure that each coach completes the coaching scholarship application form before November 2nd 2015. If you cannot locate the link to this form on the MWAS website, email mwas@sportshouse.net.au to ask for the link. Any application received after November 2nd will not be considered. It is recommended that you draft your application on a word document and then copy and paste the relevant fields into this online form. This will enable you to spend time on the application, share the responses between your SSA and RSA and will reduce the risk of losing your partially completed application if the online system malfunctions while you are writing it. This form is only to be completed by State Sporting Associations. Athletes, coaches and officials wishing to be nominated for a scholarship must speak with either their State Sport Association and/or MWAS, to ensure that they are nominated. If you do not receive a receipt confirming that MWAS has received your application within 5 days of submitting it, contact MWAS on mwas@sportshouse.net.au

* Contact name

* State Sport Association submitting this application

* Email

* Telephone

Regional Sport Association (RSA) that is a partner in this application (If applicable)

Include this if your SSA will collaborate with the RSA to provide technical and tactical coaching to athletes, and/or if the RSA will invest any finances for the development of coaches or officials on scholarship.

* I confirm that the Board or CEO of the SSA and RSA endorsed this application and all proposed scholarships.

Yes, I confirm

* Name each coach, in order of preference, for endorsement of scholarship application

If coaches not on your list apply, MWAS will contact you to confirm whether you endorse their application.

* I confirm that we have discussed this opportunity with each athlete and official that we are nominating and all of them are keen to be on scholarship in 2016 if selected.

Please ensure that you make the athletes aware that there is a $550 levy that they must pay (if your Sport will not pay it for them).
Yes, I confirm

Outline the details of any financial investments that the SSA and/or RSA will contribute for the coach scholarships. 100% of your funds invested will be spent on their development. Financial investment is encouraged, but not compulsory.

MWAS will be investing $300 cash and more than $3,000 of in-kind services to each coach on scholarship. Ignore if there will be no coaches from your sport on scholarship

How much financial investment will your Sport provide for the Officiating Scholarship/s?

Ignore if you are not nominating officials.
MWAS will provide 30 cents for every dollar that you invest, up to a maximum investment of $550 from MWAS.

What is the name, gender and shire of residence of any official/s that you are nominating for a scholarship?

Ignore if you are not nominating officials

Concise summary or bullet-points of up to approximately 250 words per official that supports the case for the nominee/s to gain an Officiating Scholarship. Specifically, how will developing this official help to raise the level of competition in the Mid West?

Ignore if you are not nominating officials

* Can your Sport meet the Sport Partnership Criteria?

You will address this criteria by answering the next 13 questions below.
We can meet the entire criteria - see our responses below
There are some components of the criteria that we cannot meet - see our responses below

1. Having at least one athlete that meets the Athlete Criteria? If not, does the Sport have multiple athletes that will likely reach the criteria within two years?

We currently have athletes that meet the criteria
We have athletes that will likely meet the criteria in 2 years
We don't have any athletes that could meet the criteria in the next 2 years

2. Utilising a fair method to select the athletes that are being nominated for a scholarship? What method was used?

Write N/A if you are not nominating athletes

3. Ensuring that MWAS athletes will be required to travel to Perth or elsewhere for training only when absolutely necessary?

Explain how you will collaborate with Mid West coaches to achieve this. Also confirm that you will liaise with MWAS so that athletes don't need to go to Perth for conditioning and fitness tests. Write N/A if you are not nominating athletes

4. Ensuring that MWAS athletes will have ongoing access to a suitably skilled and qualified technical / tactical coach? I.e. that the coach will be able to mirror the quality of coaching that athletes of the same standard will receive in Perth.

This may require the SSA or RSA to pay the coach for their services and to send a visiting high performance coach to the Mid West on multiple occasions. Write N/A if you are not nominating athletes

5. Providing the technical coach/es that work with the MWAS athletes with the necessary mentoring and support that they will require?

This may include providing support with designing technical / tactical training sessions. It may also require the SSA to send a high performance coach to assist with some sessions in the Mid West. Write N/A if you are not nominating athletes

6. Monitoring the progression of MWAS athletes and ensure that they are carefully considered for state squad / team selection?

Yes, we can do this
No, we cannot do this
We are not nominating athletes, so this is N/A

7. Proactively engaging with WAIS and/or with other more elite programs in the athlete pathway, to ensure that future progression for athletes on scholarship can be as seamless as possible?

Yes, we can do this
No, we cannot do this
We are not nominating athletes, so this is N/A

* 8. Pay a SSA contribution of $275.00 including GST towards the annual services budget for each athlete from your sport that holds a scholarship?

Yes, we can pay this fee
We are not nominating athletes, so this is N/A

9. Provide a representative to sit on the MWAS JMC for your Sport (two meetings per year)?

This can be over teleconference
Yes
No

10. Develop and execute a robust and thorough plan for the development of all coaches and officials in the Mid West?

Yes
No

11. Integrate and acknowledge MWAS in athlete and coach pathways and state high performance plan?

Yes
No

12. Recognise and promote MWAS on SSA and RSA websites, including a MWAS logo and web-link?

Returning Sports to provide a weblink as evidence of this for the current year.

13. Acknowledge MWAS in publications, such as E-News and Annual Reports?

Yes
No
If you are not nominating any athletes, your application is complete. Scroll to the bottom and submit.

Name of the athlete that you are nominating for first preference for a scholarship

Ignore if you are not nominating athletes. If you are not nominating athletes, your application is now complete. Scroll to the bottom and submit.

Date of birth

Must be aged at least 13 years on at least one day during 2016

Gender

Female
Male

Identifies as being of Aboriginal or Torres Straight Island descent?

Yes
No
We have not asked the athlete

Shire of permanent residence

Included shires: Carnamah, Chapman Valley, Coorow, Cue, Greater Geraldton (includes Mullewa), Irwin, Meekatharra, Mingenew, Morawa, Mount Magnet, Murchison, Northampton, Perenjori, Sandstone, Three Springs, Wiluna and Yalgoo. Athletes who go to a boarding school outside of the listed LGAs are not eligible for a scholarship.

Who is the athlete's coach?

Does the athlete have a disability / impairment? If so, please specify details

Statement or bullet-points demonstrating how the athlete meets the Athlete Scholarship Criteria

Selection criteria can be viewed by copying and pasting this link to your browser - http://www.mwaswa.com.au/index.php?id=126

Name of the athlete that you are nominating for second preference for a scholarship

Ignore if you are not nominating any more athletes

Date of birth

Must be aged at least 13 years on at least one day during 2016

Gender

Female
Male

Identifies as being of Aboriginal or Torres Straight Island descent?

Yes
No
We have not asked the athlete

Shire of permanent residence

Included shires: Carnamah, Chapman Valley, Coorow, Cue, Greater Geraldton (includes Mullewa), Irwin, Meekatharra, Mingenew, Morawa, Mount Magnet, Murchison, Northampton, Perenjori, Sandstone, Three Springs, Wiluna and Yalgoo. Athletes who go to a boarding school outside of the listed LGAs are not eligible for a scholarship.

Who is the athlete's coach?

Does the athlete have a disability / impairment? If so, please specify details

Statement or bullet-points demonstrating how the athlete meets the Athlete Scholarship Criteria

Selection criteria can be viewed by copying and pasting this link to your browser - http://www.mwaswa.com.au/index.php?id=126

Name of the athlete that you are nominating for third preference for a scholarship

Ignore if you are nominating no more athletes

Date of birth

Must be aged at least 13 years on at least one day during 2016

Gender

Female
Male

Identifies as being of Aboriginal or Torres Straight Island descent?

Yes
No
We have not asked the athlete

Shire of permanent residence

Included shires: Carnamah, Chapman Valley, Coorow, Cue, Greater Geraldton (includes Mullewa), Irwin, Meekatharra, Mingenew, Morawa, Mount Magnet, Murchison, Northampton, Perenjori, Sandstone, Three Springs, Wiluna and Yalgoo. Athletes who go to a boarding school outside of the listed LGAs are not eligible for a scholarship.

Who is the athlete's coach?

Does the athlete have a disability / impairment? If so, please specify details

Statement or bullet-points demonstrating how the athlete meets the Athlete Scholarship Criteria

Selection criteria can be viewed by copying and pasting this link to your browser - http://www.mwaswa.com.au/index.php?id=126

Name of the athlete that you are nominating for fourth preference for a scholarship

Ignore if you are nominating no more athletes

Date of birth

Must be aged at least 13 years on at least one day during 2016

Gender

Female
Male

Identifies as being of Aboriginal or Torres Straight Island descent?

Yes
No
We have not asked the athlete

Shire of permanent residence

Included shires: Carnamah, Chapman Valley, Coorow, Cue, Greater Geraldton (includes Mullewa), Irwin, Meekatharra, Mingenew, Morawa, Mount Magnet, Murchison, Northampton, Perenjori, Sandstone, Three Springs, Wiluna and Yalgoo. Athletes who go to a boarding school outside of the listed LGAs are not eligible for a scholarship.

Who is the athlete's coach?

Does the athlete have a disability / impairment? If so, please specify details

Statement or bullet-points demonstrating how the athlete meets the Athlete Scholarship Criteria

Selection criteria can be viewed by copying and pasting this link to your browser - http://www.mwaswa.com.au/index.php?id=126

Name of the athlete that you are nominating for fifth preference for a scholarship

Ignore if you are nominating no more athletes

Date of birth

Must be aged at least 13 years on at least one day during 2016

Gender

Female
Male

Identifies as being of Aboriginal or Torres Straight Island descent?

Yes
No
We have not asked the athlete

Shire of permanent residence

Included shires: Carnamah, Chapman Valley, Coorow, Cue, Greater Geraldton (includes Mullewa), Irwin, Meekatharra, Mingenew, Morawa, Mount Magnet, Murchison, Northampton, Perenjori, Sandstone, Three Springs, Wiluna and Yalgoo. Athletes who go to a boarding school outside of the listed LGAs are not eligible for a scholarship.

Who is the athlete's coach?

Does the athlete have a disability / impairment? If so, please specify details

Statement or bullet-points demonstrating how the athlete meets the Athlete Scholarship Criteria

Selection criteria can be viewed by copying and pasting this link to your browser - http://www.mwaswa.com.au/index.php?id=126