DIT Athlete Support Programme Application Form


All fields marked with an * are required fields:

DIT Athlete Support Programme - Closing Date 05/10/2018

DIT Athlete Support Programme
1: Personal Details
(in Kilos) (in Centimetres)

2: Academic Details
Level 6  
Level 7  
Level 8  
Level 9  

3: Sports achievements

Select your main sport

Upload an image of you in action

List your achievements in your main sport, e.g. representative honours, times, distances, scores etc.
Include the competitive standard (senior, minor etc) where applicable.:

List other sports in which you have competed and any achievements in those sports:

4: References

References from two persons (eg. Sport Club Coach/Manager, School Coach, Regional or National Coach/ Manager) must be entered

Referee 1:

Referee 2:

5: Additional Information

6: Declaration
Privacy Statement

All the information collected by the DIT Sport and Recreation Service is collected in accordance with the Data Protection Act 1988.
This information will not be disclosed to any unauthorised third parties without your consent. A copy of the Privacy Act can be obtained at

Please tick the box below to indicate that you have read the Privacy Act and agree to its terms.

Declaration Statement

I wish to be considered for a place on the Athlete Support Programme, and I declare that all the information provided in this application
(including any supporting documentation) is correct and complete. I understand that the DIT Sport & Recreation Service reserves the right to vary
or reserve any decision regarding awarding of scholarships made on the basis of incorrect or incomplete information provided in this application
and a copy of your information may be forwarded to the relevant National Governing Body to seek additional information.

Please indicate that you accept the Statement of Declaration below *