2021 Empowering People Scholarship Application Form

Eligible WA individuals from football clubs and associations are invited to apply for the 2021 Empowering People Scholarship grant using the form below. Please read the Empowering People Scholarship Terms & Conditions and/or discuss your application with Football West prior to submission. Completed applications will be processed and notified of the outcome within two weeks of the closing date - Friday 13 August 2021, 3pm WST.

Applicant First Name*
Applicant Surname*
Contact Number*
Email*
FFA Number (if applicable)
Demographic Information
This is to ensure the Empowering People Scholarship Fund reaches individuals whose circumstances might have prevented them from being able to access Football West or other courses previously.
Club/Association*
Role at Club/Association (if applicable)
Postal Address*
Postcode*
Date of Birth*
MM slash DD slash YYYY
Gender
Do you identify as Aboriginal and/or Torres Strait Islander?*
Do you identify as living with a disability?*
Do you come from a Culturally and Linguistically Diverse (CaLD) or Non-English Speaking Background?
The Culturally and Linguistically Diverse (CaLD) population as a group represents communities of people who were born overseas or who are Australian born with one or both parents or grandparents born overseas. This term refers to people who are from countries in which the main language spoken is not English. CaLD people may be referred to as people who are migrants, newly arrived refugees.
Program Details
Let Football West know what type of personal development you want support with to benefit both yourself and the football community
Course/Workshop/Professional Development Name*
Commencement Date
DD slash MM slash YYYY
Completion Date
DD slash MM slash YYYY
Program Description & Objectives*
Let us know why this is the professional development you wish to undertake and what it's all about. What barriers have you faced in trying to access this opportunity previously?
Total Program Cost*
Your Funding Request*

The Empowering People Scholarship Fund may provide a maximum of $500 per applicant
I have read the Football West Empowering People Scholarship Fund Terms and Conditions*
- Yes
How did you hear about the Empowering People Scholarship?

Save and Continue Later

2021 Empowering People Scholarship Application Form

Demographic Information

Program Details