Activator Application

Name*
First Last
Date of Birth*
DD slash MM slash YYYY
Email*
Phone*
Address*
Street Address Address Line 2 City County Postcode
Organisation
Role
Sector
Please Supply*
Please select which National Partner you are applying on behalf of
Please note that your application submission will be shared with the selected partner
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Video submission*
Accepted file types: mp4, mov, wmv, avi, avchdflv, mkv, webm, Max. file size: 256 MB.
Please upload a short video telling us why you would make a great Activator for the Inspire a Generation programme in your community.

Please make sure you cover the points noted on our Activator Skills List within your submission. (Max 1 – 5 minutes)

Maximum video size 250mb
Please let us know your kit sizes (please reference Kukri Size Guide – as you will not be able to exchange kit and it is athletic fit):
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Top*
- Men’s
- Women’s
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Top – Men's*
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Top – Women's*
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Bottom*
- Men’s
- Women’s
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Bottom Sizing*

Equality Monitoring Form

Signature	Date	Actions

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By submitting this application, you are confirming that you have read and agree to the BWB Rules, Policies and Procedures found here (https://britishwheelchairbasketball.co.uk/rules-regulations/policies/). Please note that they may be subject to change but we will keep you informed as and when these changes take place.
I agree to my details being shared with UKCRBs for DBS application purposes*
- I agree to my details being shared with UKCRBs for DBS application purposes
I agree to my details being shared with UK Coaching to register for UK Coaching Club*
- I agree to my details being shared with UK Coaching to register for UK Coaching Club
If successful your Community Activator application you will receive an email with log in details for BWB’s online learning system – BWB Learning.
Date
DD slash MM slash YYYY
Email
This field is for validation purposes and should be left unchanged.

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