Falcons Junior Representative Fund

1

Application Type

Who is completing this form?*

Parent/Guardian applying for my child Player applying for myself I am nominating another Falcons junior player

Please select an option.

Nomination Details

Name of nominated player*

Required.

Your relationship to the player*

Required.

Parent/Guardian name (if known)

Parent/Guardian email or phone (if known)

I confirm I have informed the parent/guardian of this nomination. I understand a subcommittee member will contact the parent/guardian to obtain consent and further details before any funding is approved.

Both confirmations are required.

2

Player Details

Player full name*

Required.

Date of birth*

Required.

Age at 1 January of representative year* e.g. 14

Required.

Residential suburb*

Required.

Falcons team played in this season*

Required.

Parent/Guardian name*

Required.

Email address*

Please enter a valid email address.

Phone number*

Required.

3

Representative Details

Representative team selected for*

Required.

Level of representation*

Representative Carnival Spitfires Senior Team State Championships National Championships International Representation

Please select a level.

Tournament location*

Required.

Tournament dates*

Required.

Training commitments required* Frequency, travel requirements, and duration

Required.

4

Costs & Funding Requested

Registration / nomination fees

Uniform & compulsory equipment

Travel costs

Accommodation costs

Other compulsory costs Please describe and include the amount

Total Funding Requested $0.00

The subcommittee may award less than, equal to, or greater than the amount requested at its discretion.

5

Other Funding & Support

Have you applied for or received any other grants, sponsorships or financial support for this representative opportunity?*

Yes No

Please select an option.

Please provide details* Organisation name and amount received or applied for

Required.

Have you sought assistance from the representative association or governing body?

Yes No

6

Financial Hardship

Please briefly outline why financial assistance is being requested* This information is confidential and assists the subcommittee to understand your circumstances.

Required.

Is there any additional information you would like the subcommittee to consider? Optional

7

Payment Details

Funding may be paid via direct deposit, voucher, or direct supplier payment at the discretion of the subcommittee.

Account Name*

Required.

BSB*

Required.

Account Number*

Required.

8

Promotion & Recognition

Consent is encouraged but entirely optional and does not influence funding decisions.

If successful, are you comfortable with Falcons sharing your child's achievement in recognition of support from the Fund or Naming Rights Sponsor?*

Yes, I consent to name and/or photo being used Yes, name only No, I prefer this application remain confidential

Please select an option.

9

Declaration

I confirm the information provided is true and correct. I understand applications are assessed in accordance with the Falcons Junior Representative Fund Policy. I acknowledge funding may be paid by direct deposit, voucher, or supplier payment at the discretion of the subcommittee.

All three declarations must be confirmed.

Falcons Junior Representative Fund

Application Received!