Rotary Club of Horwich Youth Achievement Awards 2024

Rotary Club of Horwich Youth Achievement Awards 2024

This application form must be completed by the applicant and NOT by a parent or guardian
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Phone Number*
Please enter a valid phone number.
Email address
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School, College or Group attended*
Activity or Pursuit for which an award is sought*
Details of achievements to date*
Details of coaching/tuition to date*
Future Prospects or Intentions (Please describe how the award would be used and, if appropriate, indicate the weekly cost) *
I wish to be considered for an award under the above scheme.
Signature*

Clear
Parent/Guardian*

Clear
A letter or images expanding any of the above should be attached if appropriate

Cancelof
Submit your application by November 1st, 2024 to the Rotary Club of Horwich Vocational Services Committee.
Name on cheque (if successful)
Should be Empty: