Club Sustainability Award 2018/19 Application Form November 2017
Introduction Completing the application form. This form has been created as a fillable PDF form. In order to complete this document electronically you will need Adobe Reader (version 8.1) or newer. This file must be downloaded and saved before being completed. If you are not using the Adobe Reader, either on a Mac or a PC, please do so. You can download Adobe Reader for both Macs and PCs here: http://get.adobe.com/uk/reader/ Mac users, please note, to complete the form, ensure that you have opened the document in Adobe Reader (version 8.1) or newer and not the Mac default Preview application. Clubs must consult their Scottish Rugby Club Services Manager for further information and guidance before submission of this application. Deadline for Submission: June 2018 Name of club contact completing form: Club Position Email Phone Funding Application: select the award levels you are targeting. 2018/19 2019/20 2020/21 Gold Gold Gold Silver Silver Silver Bronze Bronze Bronze 2
Coaching Male adult team Women & Girls Youth development Match Officials Strategic direction GOLD club coach coordinator 50% mini L1 50% youth & adult L2 L3 coach at U18 & adult Qualified S&C coach 3 teams 1 x Women s team 2 x Girls teams 13 teams across rugby community (min. 6 mini & 7 secondary teams) 1 or more L1 qualified refs per club team. Min of 2 female refs. 2 or more active society refs 1 ref secretary Have a strategic plan Financially sustainable 2 x qualified female coach SILVER club coach coordinator 33% mini L1 33% youth & adult L2 1 x L3 coach Qualified S&C coach 2 teams 1 x Women s team or 1 x Girls teams 9 teams across rugby community (min. 4 mini & 5 secondary teams) 1 or more L1 qualified refs per club team Min 1 female refs 1 active society refs 1 ref secretary Have a strategic plan Financially sustainable 1 x qualified female coach BRONZE club coach coordinator (only a CCC required in year 1-2018/19) 20% mini L1 20% youth & adult L2 (year 2) 1 team Developing Womens & Girls rugby 3 teams across rugby community 1 L1 qualified ref per 2 club teams 1 ref secretary Financially sustainable 3
Categories Current 2017-2018 2018-2019 2019-2020 2020-2021 Adult Teams (Male) 1ST XV 1ST XV 1ST XV 1ST XV 2ND XV 2ND XV 2ND XV 2ND XV 3RD XV 3RD XV 3RD XV 3RD XV 4TH XV 4TH XV 4TH XV 4TH XV Categories Current 2017-18 2018-19 2019-20 2020-21 1ST XV 1ST XV 1ST XV 1ST XV 2ND XV 2ND XV 2ND XV 2ND XV 3RD XV 3RD XV 3RD XV 3RD XV 4TH XV 4TH XV 4TH XV 4TH XV Definition of relationship with collaborating club(s). provide details of your tangible support to this collaboration; Current 2017-18 2018-19 2019-20 2020-21 Categories Current 2017-2018 2018-2019 2019-2020 2020-2021 Age- band Number Age- band Number Age- band Number Age- band Number Mini & Youth Teams U18 U18 U18 U18 U16 U16 U16 U16 S3 (U15) S3 (U15) S3 (U15) S3 (U15) S2 (U14) S2 (U14) S2 (U14) S2 (U14) S1 (U13) S1 (U13) S1 (U13) S1 (U13) P7 P7 P7 P7 P6 P6 P6 P6 P5 P5 P5 P5 P4 P4 P4 P4 4
Categories Current 2017-18 2018-19 2019-20 2020-21 Mini & Youth Teams U18 U18 U18 U18 U16 U16 U16 U16 S3 (U15) S3 (U15) S3 (U15) S3 (U15) S2 (U14) S2 (U14) S2 (U14) S2 (U14) S1 (U13) S1 (U13) S1 (U13) S1 (U13) P7 P7 P7 P7 P6 P6 P6 P6 P5 P5 P5 P5 P4 P4 P4 P4 Definition of relationship with collaborating club / school. provide details of your tangible support to this collaboration; Current 2017-18 2018-19 2019-20 2020-21 Categories Current 2017-2018 add number 2018-2019 add number 2019-2020 add number 2020-2021 add number Ageband Number Ageband Number Ageband Number Ageband Number Women & Girls Teams 1ST XV 1ST XV 1ST XV 1ST XV 2ND XV 2ND XV 2ND XV 2ND XV U18 U18 U18 U18 U15 U15 U15 U15 U12 U12 U12 U12 Categories Women & Girls Teams 1ST XV 1ST XV 1ST XV 1ST XV 2ND XV 2ND XV 2ND XV 2ND XV U18 U18 U18 U18 U15 U15 U15 U15 U12 U12 U12 U12 5
Definition of relationship with collaborating club / school. provide details of your tangible support to this collaboration; Current 2017-18 2018-19 2019-20 2020-21 Categories Current 2017-2018 2018-2019 2019-2020 2020-2021 Club Coach Coordinator Coaching: Adult TOTAL No. TOTAL No. TOTAL No. TOTAL No. UKCC L2 UKCC L2 UKCC L2 UKCC L2 UKCC L3 UKCC L3 UKCC L3 UKCC L3 UKCC L4 UKCC L4 UKCC L4 UKCC L4 S&C* S&C* S&C* S&C* FEMALE FEMALE FEMALE FEMALE 20% of youth & adult L2 (year 2) 33% of youth & adult L2 + 1 x L3 coach + 1 x female coach + qualified *S&C coach 50% of youth & adult L2 + L3 coach at U18 + adult + 2 x female + qualified *S&C coach Coaching: Youth TOTAL No. TOTAL No. TOTAL No. TOTAL No. UKCC L2 UKCC L2 UKCC L2 UKCC L2 UKCC L3 UKCC L3 UKCC L3 UKCC L3 UKCC L4 UKCC L4 UKCC L4 UKCC L4 S&C* S&C* S&C* S&C* FEMALE FEMALE FEMALE FEMALE * submit details + certificate of S&C coach qualifications Strength & Conditioning Coach Qualifications 6
Categories Current 2017-2018 2018-2019 2019-2020 2020-2021 Club Coach Coordinator Coaching: Mini TOTAL No. TOTAL No. TOTAL No. TOTAL No. UKCC L1 UKCC L1 UKCC L1 UKCC L1 FEMALE FEMALE FEMALE FEMALE Match Officials 20% of youth & adult L2 (year 2) TOTAL No. TOTAL No. TOTAL No. TOTAL No. REF SEC REF SEC REF SEC REF SEC SOCIETY REF SOCIETY REF SOCIETY REF SOCIETY REF LEVEL 1 LEVEL 1 LEVEL 1 LEVEL 1 FEMALE FEMALE FEMALE FEMALE 1 x L1 qualified referee per 2 club teams + 1 referee secretary 1 or more L1 qualified referees per club team. Min 1 female referee + 1 activie society ref + 1 referee secretary 1 or more L1 qualified referees per club team. Min 2 female referee + 2 or more activie society ref + 1 referee secretary 7
provide any further information in support of your application. For example: What is the long term plan for the club? Where do you see yourself in three years time What steps will your club need to make to achieve bronze, silver or gold in terms of coaching, number of teams, youth development and match officials? What facility changes might you need to make to accommodate the desired changes / developments? Have you budgeted for such changes / developments? What external funding is available to assist you with this? What additional committee roles / changes to committee might you require to carryout in order to fullfill your development plan? Year 1 Development Plan 8
Year 2 Development Plan Year 3 Development Plan 9
If your club has a strategic plan please email to your Club Services Manager along with your completed CSA application form. Certification Your application must be endorsed and countersigned by an authorised representative of your organisation (e.g. President, Treasurer, Secretary) other than the main contact person referred to on page 1 or the signatory to the applicant s statement on this page. Endorsement I endorse this application, confirm that I have the full authority and capacity to do so on behalf of the organisation and certify that the information provided is accurate and truthful and that the organisation has not acted fraudulently in any way in connection with this application. Signature Date Name Position Tel Number Email Applicant s Statement read and sign this statement. This is a legally binding declaration. I confirm and certify on behalf of this applicant that: I am completing this application on behalf of the organisation named on page 1; have read and understood the guidelines; and have the full authority and capacity to formally authorised this application to Scottish Rugby. All information provided in this application and its supporting documentation is accurate and truthful and that the organisation has not acted fraudulently in any way in connection with this application. I understand that any misleading statements given at any time will render this application invalid. I undertake to inform Scottish Rugby fully and immediately if any changes in circumstances require any amendment to the application or its supporting documentation. I certify that I have made full and complete disclosure of all relevant facts relating to the application, or its subject matter, whether supportive of the application or otherwise. Signature Date Name Position Tel Number Email Deadline for sumbission June 2018 10