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This form is to submit an application for the LASA Course Bursaries 2023. 

Please ensure you have read the requirements in full before submitting the application.  In order to check requirements are met, the East Midland region will access your data, and then confirm with LASA that the conditions have been met. 

Please note any approved applications are paid to the affiliated SwimMark club not individual members.

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* 1. Club

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* 2. Applicants Name

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* 3. Applicants Swim England Number 

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* 4. Bursary Type

  Qualification Discipline/Type 
Bursary for

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* 5. Course dates - (Start and end date)

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* 6. Course cost

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* 7. Confirmation that the application meets all the given requirements:
  • Submission timeline met (3 months from the date of the course certificate)
  • Member appears in the relevant role of the clubs personnel report 
  • Member has a valid DBS showing  as required 
  • Member has a valid safeguarding showing as required or is 17 and under at time of submission 

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* 8. Copy of Certificate 

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 9. Club Email - for any queries regarding the application 

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* 10. Application submitted by

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