2013 Sports Travel Grant Guide and Application ... - City of Edmonton

Both INDIVIDUAL & TEAM Applicants – Complete this Box 3
What is the name of the not-for-profit you belong to related to this application?
Local:
What is your amateur sport organization sanctioning body?
Provincial:
National:
International:
Declaration of Applicant
The applications must be signed and dated by the applicant or primary contact.
If the amateur athlete is under 18 years of age, parent is required to sign the application.
I, hereby declare that the information provided in this application is true and correct to the best
of my knowledge.
Signature:
Date:
B: EVENT INFORMATION
1. QUALIFYING EVENT INFORMATION
Complete section only if the INDIVIDUAL or TEAM/GROUP won a city and/or provincial or national
championship that qualified the INDIVIDUAL or TEAM/GROUP to advance to a Western Canadian, National or
International Competition/Event.
Name of Qualifying Event:
Date of Event:
Event Location:
Name of Sanctioning Amateur Sport Organization:
Placement in Qualifying Event:
Category (if Applicable):
Event and Results Website URL: http://
2. EVENT ATTENDING INFORMATION
List the event you are travelling to either as an individual or team.
Name of event:
Event Location:
Level (check one) Western Canadian National International
Division or Class:
Date(s) of Event:
Name of Hosting Organization:
Host Contact Name:
Address:
Phone: ( ) Fax: ( )
Organization/Event Website Address: http://
2013 Community Investment Grant Program –Amateur Sport Travel Application Page 4 of 6