Edith Cowan University
Student Services Centre – Elite Athlete Program Application Form
1. PERSONAL DETAILS
Full Name
Telephone
Best Contact Time/Day
Student Email Address
2. STUDY DETAILS
ECU Student Number
Course of Study
Credit Points Completed
3. SPORTING DETAILS
Sport(s) / Events
Highest Division Competed (include year)
4. COMPETITIVE LEVEL
Competition
Year/s
Event/Division
Senior National Squad Member
Junior National Squad Member
Senior State Representative
Junior State Representative
Other
5. SPORT SCHOLARSHIP HELD
Australian Institute of Sport
Western Australian Institute of Sport
Other State Institute/Academy of Sport
None
Note – Athletes do not have to hold a scholarship to apply for the Elite Athlete Program
Telephone: 134 328 Email: [email protected] Web: www.ecu.edu.au
6. WEEKLY ELITE SPORTING COMMITMENTS
AM
PM
PPM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Total (Hours per week)
* Indicate your typical weekly training, competition & other sport related commitments, including times for each
(ie Monday AM weights 6am-8am; Monday PM skills session 4pm-6pm; Monday PPM physiotherapy 6.30pm-7pm)
7. SPORTING CONTACTS
Name of State Sporting Organisation (SSO)
Name
Institute of Sport or SSO Contact Person
This must be a person who is authorised to
verify accuracy of information presented in
this application
Role
Phone
Email
Name
Personal Coach
Phone
Email
8. SUPPORTING LETTER
All applications require a supporting letter from the national officiating body of your sport, confirming your proof of
selection and participation at an ‘elite’ level for the current year of study.
The letter must contain the following criteria in order to be considered for the Elite Athlete Program:


Must contain a letterhead from a National Sporting body.
Must outline your current training commitments and its effect on your study load at ECU.
9. PROMOTION CONSENT
Do you consent to be contacted by ECU to support and/or attend events for promotional purposes?
Yes
☐
No
☐
Please forward the completed application form and supporting letter to [email protected].
Student Connect Activities
Student Central
Edith Cowan University
270 Joondalup Drive
Joondalup WA 6027
Telephone: 134 328 Email: [email protected] Web: www.ecu.edu.au