Scholarship Application form  

Are you new to MWAS or a continuing athlete?*

Continuing MWAS

New Athlete

Name

First Name

Last Name

Phone Number

Athlete's Mobile Number

Applicants email address - this will be used to correspond with the athlete.

Address

Parents / Guardian's Names

If applicant is under 18 please advise parent / guardian names.

Parents Preferred Contact Numbers

Parents Email Address/es

Applicant's Date of Birth

Must be aged at least 13 years on at least one day during the scholarship period.

YYYY

Gender

Male

Female

Applicant identifies as being of Aboriginal or Torres Straight Island descent?

Yes

Shire of 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).

Sport in which you participate in or play?

State Sporting Association (SSA) supporting the application

State Sport Association (SSA) approving this application (You must make contact with and obtain approval from the SSA prior to submitting this application). The SSA must be made aware of and support the applicant with the conditions of the scholarship and verify that the applicant is part of an identified talent pathway – if unsure please ensure they contact MWAS CEO on 0487 846 283 or email mwas@sportshouse.net.au for details.

Name of contact person

Please provide the name of the person who has verified and supports the application on behalf of the SSA. This person will be required to liaise with the MWAS CEO throughout the period of the scholarship.

Position held at the SSA

The position held at the SSA could include the High Performance Manager, State Team Coordinator or Development Pathway Coach?

Phone Numbers

Please include office and mobile numbers.

I confirm that the High Performance Manager or approved representative of the SSA and/ or the RSA endorse and support this application.*

The SSA must approve this application and support it.

I Agree

Who is / are the athlete's coach / coaches?

Please name the coaches that will provide the day to day technical coaching in your sport. Also provide their contact details.

MWAS will obtain ongoing feedback on your performance from your coach.

Please provide their current email address.

Uniform shirt size?

Please provide your sizes for your MWAS uniform. Please note there are differences in uniforms allowance for different levels of scholarship. (Girls sizing 6,8,10,12,14,16,18) (Boys sizing XS,S, M,L,XL,2XL)

Shorts size?

Hoodie size?

Athlete Applicants

Please provide a brief statement demonstrating how you (the applicant) meet the MWAS selection criteria. Please do not cut and paste the criteria without actually answering what and how you cover this in order to be included. This means please write about your current achievements to show why you should be selected into MWAS such as the highest level of team selected into this year or individual results achieved. Please also show other sports played and anything else you feel relevant to the application.

Athlete applicants - Goals for scholarship period

Please provide your personal goals for the scholarship period (if you are successful) and ensure you identify how you will know if you have achieved them. Use the SMART principle -Specific, Measurable, Achievable, Realistic and Time bound.

What can MWAS do to help you achieve these goals?

Tell us what you want and what you need?

Name of person completing this application

If not completed by the applicant (i.e parent / guardian)

I certify that the information provided in this application is true and correct.

Yes, I confirm the information that I have provided in this application is true and correct.