Athlete Participation FundApplication Form SECTION 1: ATHLETE INFORMATION FULL NAME OF APPLICANT: * DATE OF BIRTH * MM DD YYYY GENDER * Male Female Non-Binary Other Prefer Not to Say DO YOU IDENTIFY AS ONE OF THE FOLLOWING * First Nations Métis Inuit SECTION 2: PARENT/GUARDIAN INFORMATION NAME(S) * PHONE # * (###) ### #### EMAIL * ADDRESS * Address 1 Address 2 City State/Province Zip/Postal Code Country SECTION 3: REQUEST FOR FUNDING COMPETITION NAME * COMPETITION WEBSITE http:// COMPETITION LOCATION * COMPETITION DATE MM DD YYYY TOTAL COST OF TRIP * Including participation fees, travel, accommodation AMOUNT REQUESTED * WHO SHOULD PAYMENT BE SENT TO? * Territorial Sport Organization Parent PARENT / GUARDIAN: I certify that the information provided is accurate and complete * I agree. Thank you!
