Cambridge Champions
F.A.N.S SCHEME 
APPLICATION FORM	

Surname		
Forename (s)		
Date of Birth		
Home Tel. No. (Home)		
                        (Daytime)		
Address		

Post Code		
Email		

NGB Contact information		

Sport - involved in at National level		

The sports centre/facilities	(i)	
I am most likely to make	(ii)	
use of are:	(iii)	

I attach recent and supporting evidence of my involvement in sport at a national level (governing body endorsement if possible).  In return for the benefits of the F.A.N.S Scheme I agree to abide by the scheme conditions and to support or attend promotional activities and events if I am able.

Signed:		
Date: 		
Print name:		

Please enclose two passport-sized photos of yourself and return to:

Sports Development Service, Arts and Recreation, Cambridge City Council, 
Hobson House, 44 St Andrews Street, Cambridge, CB2 3AS.