ASA South West

Application Pack – Step by Step Guide

 Tick box when completed

This tick list is for your convenience, to act as a reminder to ensure you have completed all the
required tasks. You are not required to return this form to the office.

Application pack received

Complete Relevant Application Form

Return to ASA South West Office

Letter detailing level of Bursary received

Completion Form with receipt attached returned

to ASA South West Office when
course has been attended.

Bursary received.
 ASA South West
GENERAL INFORMATION
You need to have identified a course to attend before sending in your application form. On receipt of
the completed forms, your application will be assessed for eligibility. Successful applicants will
receive notification by letter within 14 days, this will inform you of the amount allocated.

You will need to send the ‘Bursary Award’ form back to ASA South West with a receipt for the
course fee attached, this will be issued once your grant application has been approved.

When this is received and has been processed, your club will receive a cheque for the agreed
amount directly from ASA South West. For your information, the cheque will be made payable to the
club, not the individual

PLEASE NOTE:
ASA South West is not in a position to provide double funding for applications. All sources of
funding will be taken into account prior to determining the amount of funding to be awarded.

Notes on How to Complete Bursary Application:

Most of the first form is self-explanatory. We need to know details of where, when and who has
applied for bursaries from your club previously. You will also need to get your club secretary to
authorise the application.

When you have completed all of the information on the first form you will need to complete the

Section 1. CERTIFICATE
• If you are applying for a grant towards the cost of UKCC Level 3 Coaching, please tick the
relevant box.
Section 2. CLUB (applications in Grant Aid Year – 1st April – 31st March
• You will need to check with your club secretary if the club have already applied for a bursary
within the current year. If for example, this is the clubs’ first application, you tick the ‘1 st
application box. A maximum of 6 applications per club will be considered in one Grant Aid Year.
Section 3. APPLICANTS
• If this is the first time in this Grant Aid Year that you have applied for an ASA South West
bursary, you tick the first box, if it is the second time you have applied for a bursary, tick the
second box. A maximum of 2 applications per individual will be considered in any one Grant Aid
Year.
Section 4. SWIM 21
• Ascertain clubs current position in relation to SWIM 21 (the ASA’s Club Development
Programme). Tick the appropriate box – please note subsidy is only available to clubs who have
signed up to the SWIM 21 Programme.

Now all you need to do is send it to:

ASA South West Regional Office
C/o Gloucester City Council
Herbert Warehouse, The Docks
Gloucester GL1 2EQ
 ASA South West
Individual Application Form
Bursary application for a Course Leading to ASA Certification

Name of Club: ………………………………………………………County ASA: …………………….…………….…

Club Secretary: ……………………………………………………………………………………………..……...

Club Secretary Address: ………………………………………………………………………………………….

………………………………………………………………………………………………………………………...

Post Code: ………………………….………… Telephone: …………….…………………………..……..

E mail: ………………………………………..

Has the club applied for an ASA South West bursary previously YES NO If so, when (Dates:)

Authorised by Club Secretary (Please Sign)…………………………………………………………………..

Please note that any bursary cheque will be made payable to your club.

Name of applicant:

ASA Registration no:

Current Role of applicant within club:

How long have you been a member of this club?

How many hours per week do you volunteer with the club:
If you are a paid member of club staff. Please complete below
Are you paid expenses only? YES NO
Are you paid a salary or hourly rate to work? YES NO
How many hours are you paid to work, per week?

Address of applicant:

telephone: Post code:

Email address:
COURSE TITLE

VENUE:

DATES:

ACTUAL COURSE COST:

EXTRA COSTS ie books etc.:

Please detail what these costs are for

ACCOMODATION

HAVE YOU APPLIED FOR ADDITIONAL FUNDING FROM

ANY OTHER SOURCES? YES / NO

(please note failure to document this, may result in your IF “YES” HOW MUCH? AND FROM WHICH SOURCES
bursary offer being withdrawn
 ASA South West Bursary

Please complete ALL sections ~ 1 - 6

1. Qualification Please tick Please specify which discipline
Information i.e. swimming, synchro
UKCC Level 1 Teaching
UKCC Level 2 Teaching
UKCC Level 1 Coaching
UKCC Level 2 Coaching
UKCC Level 3 Coaching

2. CLUB

Has Your club already applied for Grant Aid this year? Yes No
1st Application
2nd – 3rd Application
4th – 5th Application
6th Application

3. APPLICANTS Please tick

Have you already applied for grant aid this year?
1st Application
2nd Application

4. SWIM 21
Is your club Swim 21 Yes
accredited? No
If your club is not yet Registered
accredited, which stage in Audit completed
the process are you at? Completed an improvement
plan
Collecting evidence

For Office Use:

Date application received Date Application Processed
Total Grant aid awarded
Confirmation letter sent with bursary award form
Date cheque requested

Please note that there is a limited amount of funding for bursaries. Not all applications will be approved

Please return completed form to:

ASA South West Regional Office

C/o Gloucester City Council
Herbert Warehouse
The Docks, Gloucester
GL1 2EQ