Home / Member Hub / Provincial Sport Organization Funding / Saskatchewan Program for Athletic Excellence / Saskatchewan Program for Athletic Excellence Application Form Saskatchewan Program for Athletic Excellence Application Form Please read the instructions below before proceeding with this application. In order to be eligible for the Saskatchewan Program for Athletic Excellence you must be a Saskatchewan athlete nominated and accepted for carding status under Sport Canada’s Athlete Assistance Program (AAP). Please read the complete Saskatchewan Program for Athletic Excellence Guidelines and Criteria before proceeding with this application. APPLICATION PROCESS AND DEADLINES Athletes will apply based on your sport’s carding cycle for Sport Canada’s Athlete Assistance Program. Athletes must complete their application and submit all required documentation prior to the end of your carding cycle for your sport. Once the Canadian Sport Centre Saskatchewan has determined eligibility and funding allotments, the athlete will be notified in writing at the mailing address provided in the application. Successful applicants will receive their full eligible payment at that time. ATHLETE INFORMATIONName* First Last Date of Birth*(dd/mm/yyyy)Name of sport/discipline*Mailing Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*Email* Number of years at current address*Please list the Saskatchewan hometown that you want used for the purpose of promotion and recognition.*Period of Residency*StartTo*End Voluntary Self-Identification Sask Sport is dedicated to supporting sport participation opportunities for all Saskatchewan people. Providing a response to the following statement below is voluntary. Information provided may be used for communications with members, or participants, within our organization and/or statistical purposes in a compiled format (ONLY). Personal information will not be used or shared outside of our organization. Please choose the gender you identify with:If you prefer not to self-identify, please move on to the next question. Female Male Prefer to Self-Describe Prefer to Self-Describe Please identify your heritage:If you prefer not to self-identify, please move on to the next question. Status Non-Status Métis Inuit Prefer to Self-Describe Heritage Are you an individual living with a disability?If you prefer not to self-identify, please move on to the next question. Yes No Prefer to Self-Describe Disability ATHLETE ELIGIBILITYI am applying as an athlete training in Saskatchewan?* Yes No If no, I am applying based on one of the exceptions:* I am training out of province as part of a formal NSO-sanctioned training program. I cannot receive the required level of training in Saskatchewan and as a result have relocated out of the province (Ex. due to lack of facilities, coaching, competition, national team requirements). I am attending a post–secondary institution out-of-province. Other extenuating circumstances that require me to be out of the province. Please indicate:*I am a product of the Saskatchewan sport system because a significant and/or relevant portion of my sport development occurred while a primary resident of Saskatchewan?* Yes No Are you currently registered with the Canadian Sport Centre Saskatchewan?* Yes No Are you currently receiving funding from any other Provincial Athlete Assistance programs?*(Ex. Podium Alberta, Quest for Gold Ontario Athlete Assistance Program, etc.) Yes No If yes, which province?*Have you completed the Canadian Centre for Ethics in Sport drug awareness training?* Yes No Have you ever received a sanction from the Canadian Centre for Ethics in Sport or the World Anti-Doping Agency?* Yes No If yes, please include pertinent details below:Date*(dd/mm/yyyy)Are you currently serving a suspension of any kind?* POST-SECONDARY ATHLETIC SCHOLARSHIPAre you receiving a Post-Secondary University Athletic Scholarship?* Yes No If yes, what kind?* NCAA Canadian Interuniversity Sport Other Please indicate:* PLEASE NOTE: The Applicant will be required to acknowledge that they are solely responsibility for determining the possible impact accepting Saskatchewan Program for Athletic Excellence funding with respect to current or future NCAA scholarship eligibility. The NCAA may be contacted at: www.ncaa.org NCAA Eligibility Centre P.O. Box 7110, Indianapolis, IN 46207 1.877.262.1492 SPORT CANADA AAP HISTORYTo be eligible to receive the Saskatchewan Program for Athletic Assistance, you must be a Sport Canada carded athlete. Please identify your carding status:* C1 SR S1 DEV How many months per year are you funded?*Please enter a number from 1 to 12. DECLARATIONS The information I have provided on this grant application is true, complete and correct and I, the applicant, have personally provided it. I understand that the Canadian Sport Centre Saskatchewan (CSCS) may decline this application: If I don’t meet the guidelines for the program. If I have submitted any false statements or concealed a relevant or significant fact as both constitute misrepresentation. If I do not comply with any request for information required by the CSCS to effectively administer and maintain the integrity of the program. In return for any assistance provided to me under the CSCS’s Saskatchewan Program for Athletic Excellence, I agree to fulfill all training and competition commitments as set out in my NSO/Athlete Agreement. I am responsible to avoid the use of banned substances and practices that contravene the rules of the World Anti-Doping Agency and the rules of their International Federation or the Canadian Policy Against Doping in Sport. I will represent Saskatchewan in a positive manner, and publicly declare support I receive through the CSCS. I will make a public appearance on behalf of the CSCS and/or the Ministry of Parks, Culture and Sport if requested to do so, at a mutually agreeable time. I am solely responsible for making all necessary investigations with the National Collegiate Athletic Association (NCAA) or other athletic organizations as necessary, to determine whether receipt of assistance from the CSCS would negatively affect my status as an amateur athlete or my eligibility to receive athletic or academic scholarships. I confirm that CSCS has given me no assurances and made no representations in this regard. I will not make any claims against the CSCS, Sask Sport or the Government of Saskatchewan in this regard. I am solely responsible for determining whether receipt of assistance under the Saskatchewan Program for Athletic Excellence would negatively affect my eligibility for income support from other scholarships, bursaries or student financial assistance programs, disability or other pensions, social assistance programs or other income. AUTHORIZATION TO COLLECT AND DISCLOSE PERSONAL INFORMATION Authorize the CSCS to collect and disclose information about me that is necessary to verify my eligibility for the Saskatchewan Program for Athletic Excellence grant when consulting with the following third parties: Sask Sport Province of Saskatchewan Other Provincial / Territorial Governments The Government of Canada, including Sport Canada’s Athlete Assistance Program The Canadian Centre for Ethics in Sport Authorize the CSCS to disclose, as necessary my name and contact information to my local Member of the Legislative Assembly (MLA) and authorize my MLA to collect this information. Authorize the CSCS and the Province of Saskatchewan to disclose, as necessary, my personal information to the public including my name, hometown, image and list of accomplishments for the purpose of promoting the Saskatchewan Program for Athletic Excellence. I understand and agree that this information will be disclosed without charge in Saskatchewan Program for Athletic Excellence promotional materials, broadcasts, press releases, websites and other communications and publications prepared by CSCS and/or the Province of Saskatchewan. CONSENTBy signing and submitting this form:Consent* I certify that I have read and consent to all of the declarations listed above. Consent* I give my authorization to collect and disclose my personal information as listed above. Name of Applicant*Date*(dd/mm/yyyy)Name of Parent or Legal Guardian(Required if applicant is under 18)Date(dd/mm/yyyy) CAPTCHA