Nottingham Trent University
2016-17 Sport Scholarship Application Form
Please complete electronically where possible
Personal Details
Title
Surname
First name
Date of Birth
Height
Weight
Term-Time Address
Home Address
Tel
Mobile
E-mail
Twitter
Course Details
Course studying /applied for
Department or School
Year of Study (1st/2nd/3rd/4th)
Total Course Length
(Years)
Academic Tutor
(if known)
Student / UCAS ID
Sport Details
Sport
Discipline / Position
Current Performance Level/Ranking:
Please Specify:
- International level (Junior/Senior)
- National level (UK, County, World)
- League?
- Team (1st, 2nd Junior, Senior)
An example: GB Rank 2nd in Junior
Team and Premier Division within
Nottingham
Page 1 of 3
Edited by AB on 27.03.12
Nottingham Trent University
2016-17 Sport Scholarship Application Form
Current Club (s) (Please specify if you will be competing in these clubs during your time at NTU)
Previous Sporting Achievements (Please specify international and national competitions)
Sporting Aims & Ambitions (Please specify Short-term and Long-term goals)
Why should you be awarded a Sport Scholarship?
Page 2 of 3
Edited by AB on 27.03.12
Nottingham Trent University
2016-17 Sport Scholarship Application Form
Additional Information (What Sport Science support have you previously received, Injury
information)
Media Evidence
Please accompany your application form with the following:
 Video footage of 3-4 Clips from separate competition fixtures – Please specify the competition
 Photo – Of yourself in sporting action representing your highest representative club
N.B. Only the following sports are required to submit Video Footage:
-
Basketball
Cricket
Football
Futsal
Hockey
Volleyball
-
Lacrosse
Netball
Rugby League
Rugby Union
Reference Details (Coach or NGB Contact)
Name
Position
Club or NGB
Address
Email
Tel
PLEASE NOTE:
Applications will not be considered without a reference and either a student ID or UCAS number
and a supporting statement.
Successful selection is subject to agreement of the terms and conditions in the Athlete Contract and
each applicant reserves the right to withdraw from the process at any time.
Declaration (Applicant)
I certify that the information in this application is correct to the best of my knowledge:
Signed
Date
Please send your completed application form to as soon as possible:
[email protected]
If you have any queries please don’t hesitate to contact:
Letitia Price, High Performance Sport Officer
NTU Sport Department
Email: [email protected]
Tel: 0115 848 3467
Page 3 of 3
Edited by AB on 27.03.12