Boxing Investment Programme Expression of Interest 1
Section A: Information about the Applicant Club Details Official name of your organisation: Club Address: City/Town: Postcode: Are you currently affiliated to the Irish Amateur Boxing Association: Yes No If No when were your previously affilated: Year: Main Contact Details Name of main Contact: Position: Address: City/Town: Telephone: (Day): (Evening): (Mobile): Postcode: E-Mail: Web: Club Membership Number of Males: Age 0-17: Age 18-49: Age 50+ Number of Females: Age 0-17: Age: 18-49: Age 50+ Financial Questions Does the club produce annual accounts or income & expenditure statements: Yes: No: Has the club received any funding in the last 5 years i.e. 1/1/2007 2
Section B: Equipment Requirements See below a list of equipment that may be available under the Boxing Investment programme: Under equipment Quantity please put down the number of items already owned. Under please indicate the number of items you require. Gloves: Bag 10oz Blue Blue Blue Red Red Red Leather with velcro fastening 12oz Leather with velcro 14oz Leather with velcro 16oz Leather with velcro 12oz Leather with velcro 14oz Leather with velcro 16oz Leather with velcro Head guards: Full Face type SMALL (leather & velcro fastening) Full Face type MEDIUM (leather Full Face type LARGE (leather & velcro fastening) Full Face type XLARGE (leather Full Face type SMALL (leather & velcro fastening) Full Face type MEDIUM (leather Full Face type LARGE (leather & velcro fastening) Full Face type XLARGE (leather Open Face type SMALL (leather Open Face type MEDIUM (leather Open Face type LARGE (leather Open Face type XLARGE (leather 3
Open Face type SMALL (leather Open Face type MEDIUM (leather Open Face type LARGE (leather Open Face type XLARGE (leather SMALL - AIBA Standard MEDIUM - AIBA Standard LARGE - AIBA Standard XLARGE - AIBA Standard SMALL - AIBA Standard MEDIUM - AIBA Standard LARGE - AIBA Standard XLARGE - AIBA Standard Guards: Female Abdo Female Abdo Female Abdo Female Abdo Male Abdo Male Abdo Male Abdo Male Abdo Leather - SMALL Leather - MEDIUM Leather - LARGE Leather - XLARGE Leather - SMALL Leather - MEDIUM Leather - LARGE Leather - XLARGE Protectors: Female Body Female Body Female Body Female Body Male Body Male Body Male Body Male Body Leather - SMALL Leather - MEDIUM Leather - LARGE Leather - XLARGE Leather - SMALL Leather - MEDIUM Leather - LARGE Leather - XLARGE 4
Punch Bags/Chin Up Bag: Angle/Upper Cut Free Standing Hanging Chin Up - (with chains, swivel & brackets 60lbs) (with textile filling, 50lbs) (with chains, swivel, brackets & D Rings 70lbs) Wall Mounted Ball: Floor to Ceiling Medicine Medicine Medicine Speedball (complete, with adjustable leather straps) 3KG 5KG 10KG (complete set, platform & pro bearing swivel) Pads: COACH FOCUS HOOK Ring Corner Pads Leather Coach type pads (set) Leather Focus type pads (set) Leather Hook & Jab type pads (set) Set of 4 pads (Foam, PVC) Ropes: Ring Ropes Skipping NYLON Skipping LEATHER Skipping SPEED 24ft x24ft ring rope set only Nylon rope (size 8 or 9 feet) Leather rope (size 8 or 9 feet) Speed rope (size 8 or 9 feet) 5
Ring: Training Ring Training Ring Training Ring Ring 16ft x16ft complete (full set, canvas, ropes,etc)height: 1.5ft 18ft x18ft complete (full set, canvas, ropes,etc)height: 1.5ft 20ft x20ft complete (full set, canvas, ropes,etc)height: 1.5ft 24ft x24ft complete (full set, canvas, ropes,etc) Canvas: Ring Canvas Ring Canvas Ring Canvas Ring Canvas 16 x 16 (outside the ropes) 18 x 18 (outside the ropes) 20 x 20 (outside the ropes) 24 x 24 (outside the ropes) Underlay: Ring Undelay Ring Undelay Ring Undelay Ring Undelay 16ft x 16ft set (outside the ropes) 18ft x 18ft set (outside the ropes) 20ft x 20ft set (outside the ropes) 24ft x 24ft set (outside the ropes) Other: Clock: Electronic Computer: Boxing Scoring Exercise Bike Rowing Machine Treadmill Floor Mats First Aid: Box/Kit Defibrillators Scales: Portable/Electronic Aerobic Steps Weights Rack Dumbbell set Hand Wraps Timing Clock AIBA Standard scoring computer Exercise/spin bike type Electronic rowing machine Electronic treadmill Heavy duty, mat size 1 meter sq x 1.5 meter sq Standard first aid box/kit Defibrillator and approved training Scales approved to 93/42/EE Aerobic step (plastic) Olympic Standard (free standing weights rack) 1 to 10kg set - total 140kgs AIBA Approved Stretch material MIN 2.5mm to 4.5mm 6
Section C: Building Requirements Please complete the following section if you wish to be considered for a building project at your club. Club Details Club Address: City/Town: Postcode: Do you own the premises : Yes No If No Do you have a lease: Yes No Years Remaining: List of Works : Details Tick New Changing Rooms/Facilities New Toilets Structural Work: Showers Structural Work: New Roof Structural Work: Access Stairs Structural Work: Insulation Structural Work: New Heating Structural Work: Plumbing Structural Work: New Lighting Structural Work: New Floor Structural Works: New Electrics Structural Work: Lift Structural Work: New Brick Work Prefab Other Please 7
Section D: Signature of Form First Signatory: Second Signatory Print Name: Print Name: Official Position: Signature: Date: Official Position: Signature: Date: Thank you for completing the expression of interest form. Sport Northern Ireland will contact you if any further information is required. You should photocopy the completed form for your own records. Completed expressions of interest must be submitted by close of play Wednesday 26 th September 2012. Please post completed forms to: William Devlin Boxing Investment Programme Sport Northern Ireland House of Sport 2a Upper Malone Road Belfast BT9 5LA If you have any questions please contact William Devlin on: Tel: 02890 383834 E-mail: williamdevlin@sportni.net 8