Elite Athlete Recognition Application
To apply, complete this form and email to the University of Tasmania EAFU contact officer
elite.athlete@utas.edu.au or return a hard copy to the Student Centre at your relevant campus to the
attention of Unigym Elite Athlete Coordinator. This form is to be completed annually.
.au
PERSONAL DETAILS
TITLE
SURNAME
GIVEN NAME(S)
DATE OF BIRTH
RESIDENTIAL ADDRESS
GENDER
__ __ / __ __/ __ __ __ __ (DD/MM/YYYY)
FEMALE
MALE
UNSPECIFIED
TELEPHONE No. (H) __ __ - __ __ __ __ __ __ __ __
TELEPHONE No. (M) __ __ __ __
POSTCODE
__ __ __
__ __ __
EMAIL ADDRESS
UTAS
PERSONAL
Member Tasmanian Institute of Sport
YES/NO
Cricket Tasmania
YES/NO
Other organisations/institutions___________________________
COUNTRY OF BIRTH
NATIONALITY
SPORT DETAILS
SPORT
CLUB/LOCATION/TEAM
CURRENT LEVEL
ACHIEVEMENTS Note: These details will be checked annually by the UTAS EAFU contact officer
STUDY DETAILS
STUDENT NUMBER
FACULTY
COURSE TITLE
FULL TIME
PART TIME
DISTANCE LEARNING
YEAR COMMENCED
CAMPUS
COMPLETION YEAR (Approx)
I FOUND OUT ABOUT THE ELITE ATHLETE OPPORTUNITIES VIA:
University of Tasmania website
Unigym
Coach
CDE staff
UTAS student
My faculty
Other_________
A LETTER OF REFERENCE FROM YOUR SPORTING ORGANISATION (signed by a coach, trainer or program
administrator), IS TO BE SUPPLIED WITH THIS APPLICATION. Please list your Referee below. For a letter of reference
example, please refer to page 2 of this application form.
REFEREE NAME
POSITION
TELEPHONE
EMAIL
PROPOSED SCHEDULE OF SPORTING EVENTS (e.g. Competitions, meets, interstate trips etc). If additional room is
required, please attach a separate document detailing events. Please note that the below sporting schedule does not need to be
completed by TIS scholarship students or Elite Athletes at Cricket Tasmania.
January
February
March
April
May
June
July
August
September
October
November
December
STUDENT SIGNATURE. I agree that the information on this form is true and correct. I also agree to assist, where possible,
with University media, marketing and research studies (photos, surveys, interviews etc).
Date __ __/__ __/__ __ __ __
SIGNATURE
OFFICE USE ONLY
Date Received
Approved By
Contacted by
Added to database
PRIVACY COLLECTION STATEMENT
The information on this form is collected for the primary purpose of the Elite Athlete Friendly University program. If you choose not to complete all the questions on this form, it may not be
possible for UTAS to assist you as a student athlete. Personal information may also be disclosed to University of Tasmania faculty contacts.
Elite Athlete Recognition Application –
page 2
THIS IS AN EXAMPLE OF A LETTER TO BE SUPPLIED BY A COACH, TRAINER OR PROGRAM ADMINISTRATOR
TO SUPPORT YOUR APPLICATION. PLEASE NOTE THAT THIS LETTER DOES NOT NEED TO BE SUPPLIED
BY ATHLETES WITH A TASMANIAN INSTITUTE OF SPORT SCHOLARSHIP, OR BY CRICKET TASMANIA
RECOGNISED ELITE ATHLETES.
Authorising Organisation’s
Letterhead
[DATE]
EAFU Contact Officer
University
of completed
Tasmania form via email to careersevices@utas.edu.au
Please return
Private Bag 45
HOBART TAS 7001
TO WHOM IT MAY CONCERN
RE: Endorsement of [Athlete’s Name] for Elite Athlete Status
This letter confirms that [Athlete’s Name] is currently competing as an Elite Athlete in [their nominated sport] during
[year].
I confirm that [Athlete’s Name] meets the EAFU guidelines provided for Universities assessing non-identified athletes for
Elite Athlete status (please tick all that apply):





Is currently representing Australia in their given sport
Has recently qualified for a major event such as a world championships
Is representing their state in a senior team
Has a high level of training, competition and travel demand related to their sport e.g. over 15 hours per week
Other [please give details]
Regards,
[Signature]
[Printed Name]
[Job Title & Organisation Name]