BOXING CANADA - Canadian Athletes Now
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ATHLETE FUNDING APPLICATION FORM
IMPORTANT INFORMATION:
Please note that applications must be completed in full and submitted by the application deadline in order to be considered by our selection committee.
Your application can be done ONLINE via our website MyCANFund.ca or it may be mailed to:
Canadian Athletes Now Fund
106 Berkeley Street
Toronto Ontario, M5A 2W7
Athlete Application Deadline
• Deadline: Friday, October 19th, 2018 @ 5 pm EST,
SUMMER & WINTER athletes are eligible to apply
Eligibility:
• Applications will be accepted from any active national team athlete who is training to represent Canada Internationally.
• Summer, Winter, Able-bodied and Paralympic athletes can apply.
• Each approved athlete recipient receives direct funding of $6,000.
• There are 2 applications a year. Each application is a NEW application. If you have received the CAN Fund already this year you are still eligible to receive it again
• Application distribution channels include, AthletesCAN, National Sport Organizations (NSO’s) and the Canadian Athletes Now Fund database.
Selection Process:
• All Athlete Applications are reviewed by our Selection Committee subject to the criteria established by the Canadian Athletes Now Fund Board of Directors. This criteria includes, but is not limited to:
• The applicant’s current World and Canadian rankings
• The applicant’s financial summary
• Application content
• Full completion of the application
• Prior to the announcement of each successful applicant and the distribution of funds, all information provided by the applicants is confirmed with each National Sport Organization.
• Each successful athlete will be notified by phone prior to a posting of their name on the
CAN Fund website MyCANFund.ca.
• The amount of funds distributed for each application is dependent on the amount of money raised through CAN Fund fundraisers, public donations, Corporate Canada, CAN Fund Alumni, Foundations and other donors.
SECTION A: Personal Information
Submission date: Deadline: Friday, October 19th 2018 (5pm EST)
1. First Name: _______________________ Surname: ____________________
2. Telephone: Home _____ - ______________ Cell _____ -______________
3. Email address: __________________________________________________
4. Date of Birth: Month _______ Day _______Year ___________
5. Hometown: _____________________
6. Parents Contact Information:
Name(s):_____________________________________________________
Phone Number(s): _____________________________________________
Email(s): ___________________________________________________
SECTION B: Athletic Information
1. Sport: ___________________________ Event: _____________________
2. Main Training City_______________________________
3. CURRENT Canadian ranking: Individual ______ Team (if applicable) ______
4. CURRENT World ranking: Individual ______ Team (if applicable) ______
5. Are the rankings you provided at the Junior or Senior level?
6. Coach(es)
Name(s): ______________________________________________________
Phone number(s):________________________________________________
Email(s): ______________________________________________________
7. Are you carded: □ Yes □ No If YES, what level? __________
8. Besides financial support, what else would be useful? _________________________________________________________________
SECTION C: Financial Information (Financial situation based on your upcoming 2018/2019 training and competitive season)
ANNUAL INCOME:
Work: Net annual income $ _____________________
School: grants, scholarships $ _____________________
Sponsorship: (specify) _________________________ $ _____________________
Carding: Senior / Development $ _____________________
Bonuses: prize money, competitions, other $ _____________________
Other: (please specify) _________________________ $_____________________
appearance/speaking fees, etc.
TOTAL ANNUAL INCOME $ _____________________
ANNUAL EXPENSES:
A) Living expenses
Housing: rent/mortgage $ _____________________
Utilities: cable, phone, hydro, gas, etc. $ _____________________
Transportation: car, bus, gas, insurance, etc. $ _____________________
Food/nutrition: $ _____________________
Other: (please specify) ______________________ $ _____________________
B) Training/Competition expenses
**DO NOT INCLUDE any expenses covered by your sports federation or your sports club. Only include costs and/or portions you are personally responsible for**
Travel: $ _____________________
Accommodation: $ _____________________
Coaching: $ _____________________
Club/team fees: $ _____________________
National Team team fees: $ _____________________
Equipment: $ _____________________
Other: (please specify) ______________________ $ _____________________
TOTAL ANNUAL EXPENSES $ _____________________
**NET INCOME (annual income minus annual expenses) $ _____________________
Please note: Applicants may be asked to provide a recent “Notice of Assessment” in order to verify income statements.
Please provide a reference (who has known you for at least 5 years and is not a
family member or friend) to validate the above information.
Reference name: _____________________________ Title: __________________
Phone number: ____________________ Email: ___________________________
SECTION D: Additional Information
1. We are inviting schools across the country to “Join the Journey”, please share your school contact information.
Middle School:_____________________ High School:__________________
Contact:__________________________ Contact:_____________________ Email__________________________ __ Email:_____________________
Phone:___________________________ Phone:______________________
2. In your own words, please express to the selection committee why you are seeking funding from the Canadian Athletes Now Fund, and what the funds would be used for/how they would impact your training. (You can attach your answer on a separate piece of paper)
SECTION E: Athlete Referrals
At CAN Fund we continue to build a culture of “Athletes Helping Athletes” where athletes come together to help each other succeed. With a record number of athletes relying on CAN Fund for financial support we need everyone to work together by sharing CAN Fund in your networks so that we can continue to fund the greatest number of athletes possible. Many Canadians want to help but they just don’t know how or that CAN Fund even exists! Do you have 1-3 contacts in your network or your parents network that you think would be interested in learning more about CAN Fund and the different ways they can get involved. If so, please refer them to us and we will reach out to them directly.
The connections we are looking for are proud Canadians who are entrepreneurial, small to medium sized companies or business owners and executives, law firms, oil & gas, finance etc. Sport related companies and organizations tend not to fit our donor profile. Also, contacts that are already supporting or sponsoring athletes are already giving and doing their part so we are looking for new people to introduce as we do not want to take away from any of your personal sponsorships.
1. REFERRAL
First Name: __________________ Surname: _________________________
Business Title: ___________________________________________________
Company: _______________________________________________________
Phone: _________________________________________________________
Email Address: ___________________________________________________
2. REFERRAL
First Name: __________________ Surname: _________________________
Business Title: ___________________________________________________
Company: _______________________________________________________
Phone: _________________________________________________________
Email Address: ___________________________________________________
3. REFERRAL
First Name: __________________ Surname: _________________________
Business Title: ___________________________________________________
Company: _______________________________________________________
Phone: _________________________________________________________
Email Address: ___________________________________________________
SECTION F: Build Success By Celebrating The Impact of Others
(you can attach your answers to a separate sheet of paper)
1. What is your favourite song to work out to? Song Title and Artist/Band
2. Who is one person who has significantly impacted your life? Share 3 Words that embody who this person is to you.
This is a special opportunity to celebrate a key person who has made an impact on your life. It could be someone who believed in you before you believed in yourself. Someone who gave you your first break. Someone who cheered you on when life was going well and cheered you on when you were faced with adversity…The idea here is to try to think of someone outside of your immediate family. Someone who maybe didn’t have to be there for you and likely isn’t even aware of the impact they have had on you.
First and Last Name of your key person: _________________________________
3 Words to describe them: _____________, ______________, _______________
3. What is the biggest hurdle you have overcome to get to where you are today?
4. What advice would you give to young kids or adolescents about following their dreams? Or What is the best advice you have ever received?
5. What is the best part about wearing the maple leaf? Or Why are you proud to be Canadian?
CAN Fund Athlete Code: If you become a CAN Fund recipient, at some point in your life as a CAN Fund Alumni you agree to donate back to CAN Fund to continue the giving circle. Athletes Helping Athletes #CANFund Impact
Yes No (please circle)
I certify that all information given in this application is complete and true. I will notify the Canadian Athletes Now Fund Corporation of any change to this information as contained herein. I authorize the Canadian Athletes Now Fund Corporation to verify any information contained in this application.
Furthermore, I agree to have my name, photo and/or likeness used by Canadian
Athletes Now Fund in promotional materials used to generate support for the Fund, including but not limited to use on the official Canadian Athletes Now Fund website and in media materials (print, television, radio) highlighting the Fund. If requested, I agree to be involved in media interviews and/or make personal appearances on behalf of the Canadian Athletes Now Fund.
________________________________ _________________________
SIGNATURE DATE
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CANADIAN ATHLETES NOW FUND
106 Berkeley Street
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Tel: (416) 487-4442 Toll free: 1-866-937-2012
MyCANFund.ca
Email: athleterelations@CanadianAthletesNow.ca
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