To qualify, recipients must live, attend school or belong to a club based in Surrey. Please check the box/boxes below that apply (required):

I live in, or near to the Surrey areaI go to school/college in, or near to the Surrey areaI train at a club based in, or near to the Surrey area

Your Details

Your Name (required)

Your Age (required)

Your Email (required)

Your Telephone Number (required)

Your Address

Address line 1 (required)

Address line 2

Address line 3

Town/City (required)

County

Postcode (required)

Guardian's Details (if applicable)

Your Guardian's Name (if under 18)

Your Guardian's Email

Your Guardian's Telephone Number

Please provide a brief description of your sporting interests, including membership of any clubs, your training schedule and recent competitive activities (required):

Please specify your current level of competition/representation (required):

New to the sportLocalCountyRegionalNationalInternational

Please describe your aspirations in your chosen sport (required):

The Dylan Howells Foundation is a registered charity and makes awards based on need. Evidence of need could include receipt of tax credits, school lunches, housing benefit or other state-recognised needs-based programmes. Please provide a brief description of any such benefits you/your family receive and provide any other information that could help the Foundation in making a determination of need:

Are you in receipt of any other form of funding/financial support for your sporting activities (required)?

YesNo

If you have a particular funding request in mind, please describe this below. Typical funding might include assistance with training costs, club membership fees, funding to purchase or upgrade essential equipment, etc. If the Foundation decides some form of support may be appropriate, various options will be discussed.

Please attach a letter of support from an independent person/organisation. This could be, for example, your coach, a teacher or a member of a professional body who can vouch for your commitment, achievements and potential (required).

I have read the DHF Privacy Policy, and agree to my submitted data being used to assess my application in accordance to with the policy.