Elite Athlete Gold Card Scheme

Elite Athlete Gold Card Scheme

Application Form
Personal Details
Name*

First NameLast Name
Date of Birth

MonthDayYear
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please upload a passport type photograph (head and shoulders)*

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National Governing Body of Sport

Details
Your Sport*
National Governing Body of Sport (NGB) Name*
National Governing Body of Sport is recognised by a Sports Council or affiliated to a NGB that is recognised by a Sports Council

YesNo
NGB Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
NGB Contact Person *

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
NGB Letter

It is essential that you provide us with a letter from your National Governing Body of Sport supporting your Elite Gold Card Application.
It must confirm:
- You have been selected or qualified for international duties, following a performance-based process, to represent their sport at a National (e.g., Irish, British, Home Nations) European, and/or International (e.g., World / Olympics / Commonwealth) event (e.g., tournament / competition / match / final).
- You are competing at the highest level within their event e.g., category A, Grade 1 etc.,
- Details of the event/s taking place in the next 12 months
File Upload*

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Details of forthcoming Events / Competition in the next 12months
Competition Details e.g., location, date etc*
Competition Details e.g., location, date etc
Competition Details e.g., location, date etc
Facilities

If your application is successful, please can you indicate below by ticking the appropriate box, the facilities that you would wish to use.
Bawnacre Centre, Irvinestown - Fitness SuiteCastle Park Leisure Centre, Lisnaskea - Fitness SuiteOmagh Leisure Complex - Fitness SuiteOmagh Leisure Complex - Swimming PoolOmagh Leisure Complex - Athletics Track
Data Protection

In accordance with the Data Protection Act (as amended from time to time), Fermanagh and Omagh District Council has a duty to protect any information we hold on you. The information you provide on this form will only be used for the purpose of Elite Athlete Gold Card Scheme and will not be shared with any third party unless law or regulation compels such a disclosure. For further information on how we hold your information, please visit the Privacy section on the Council website HERE
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Elite Athlete Gold Card Scheme

Personal Details

National Governing Body of Sport

NGB Letter

Details of forthcoming Events / Competition in the next 12months

Facilities