The Lord's Taverners ACT

Looking for support to help you follow your sporting dreams?

Please complete the form below so we can find out more about you and your particular needs.

Apply for Support

Section 1- Personal Details

Personal details of applicant

First Name *

Surname *

DOB *

Sex: *

Male

Female

Other

Address *

Suburb *

State *

Postcode *

Phone *

Email *

If under 18 years of age: Personal details of parent or guardian. If the applicant is over 18, please skip to Section 2.

Parent or Guardian First Name

Parent or Guardian Surname

Phone

Relationship to Applicant

Section 2 - Application Details

In what sport or activity do you participate? *

Why are you applying for support? Reasons could include social/economic distress, disability or health. *

For how much funding are you applying? *

If your application is successful, how do you plan to use the funds? *

Are you registered with a sports or other organisation? If yes, which one? *

Section 3 – Acknowledgement & Submission

I acknowledge that the information provided in this form is, to the best of my knowledge, true and accurate. I also acknowledge that any application is subject to approval. *

I agree

Name of person making the application *

Thank you for your application. We’ll be in touch shortly.

There was an error trying to send your message. Please try again later.

Apply for Support

Apply to pursue the sport of your choice, achieve your personal goals, and enjoy a better quality of life.

Apply for Support

Section 1- Personal Details

Personal details of applicant

If under 18 years of age: Personal details of parent or guardian. If the applicant is over 18, please skip to Section 2.

Section 2 - Application Details

Section 3 – Acknowledgement & Submission