Queens University Belfast open day Sunday 6th October

Queens University Belfast open day Sunday 6th October

Inspiration for Sport

Rowing

APPLICATION FORM
(Please complete application form in BLOCK CAPS)

PERSONAL DETAILS

NAME: _____________________________________________

HOME ADDRESS: _____________________________________

___________________________________________________

HOME NUMBER: _________________________ DATE OF BIRTH: _________________
MOBILE NUMBER: ________________________EMAIL ADDRESS: ___________________________

CLUB or SCHOOL NAME: ______________________________________

CLUB or SCHOOL ADDRESS: _______________________ SCHOOL NO: _________________

_______________________

_______________________

 

 

GCSE / JUNIOR CERT RESULTS: (Please enclose a copy of your GCSE / JNR CERT results)
SUBJECT                                              GRADE                  SUBJECT                                              GRADE
______________________    ____________      ______________________    ____________
______________________    ___________        ______________________    ____________
______________________   ____________       ______________________    ____________
______________________    ____________      ______________________    ____________
______________________   ____________       ______________________    ____________

_____________________   ______________    _______________________  ____________

 

AS LEVELS or LEAVING CERT (If repeating)
SUBJECT                                              GRADE                  SUBJECT                                              GRADE
______________________    ____________      ______________________    ____________
______________________    ___________        ______________________    ____________
______________________   ____________       ______________________    ____________
______________________    ____________      ______________________    ____________
______________________   ____________       ______________________    ____________

 

A LEVELS / LEAVING CERT (PREDICTED)
SUBJECT                                              GRADE                  SUBJECT                                              GRADE
______________________    ____________      ______________________    ____________
______________________    ___________        ______________________    ____________
______________________   ____________       ______________________    ____________
______________________    ____________      ______________________    ____________

 

Interested in going to University?   YES/NO          Which subject area(s) ________________________

 

Rowing profile
(Tell us about your rowing career to date)

 

­­­­­­­­­­­­­­­­­­­­

 

__________________________________________________________________________________

Your Coaches

Name:                                                   Ph No:                                   e-mail:

 

Name:                                                   Ph No:                                   e-mail:

______________________________________________________________________________

 

 

 

 

 

ROWING ACHIEVEMENTS:
Please list any rowing results you have recorded over the last few years which you believe may be of interest to us.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

OTHER INFORMATION:
Please let us know why you should be awarded a place on this one day Inspiration for Sport Event (Rowing) at Queen’s University Belfast, and what course you would like to pursue.
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PLEASE RETURN THIS APPLICATION FORM NO LATER THAN WEDNESDAY 2 OCTOBER 2013 AT 12PM.

 

RETURN TO;

Natalie Chambers

Queen’s Sport

Physical Education Centre

Botanic Park

Belfast BT9 5EX

or

e-mail:  n.chambers@qub.ac.uk

 

Enquiries to; Mick Desmond m.desmond@qub.ac.uk   +44(0)7588277121 or Anthony McGrath a.mcgrath@qub.ac.uk

 

QUB open day Sunday 6th October - anyone possibly interested in applying to Queen’s next year please contact Keith Leighton Club Captain.

September 22nd, 2013

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