Sport Membership Application Form

Sport Membership

Application Form

Use this form to apply for CSSC's Sport Membership Funding

Your Details

First Name*

Surname*

Email Address*

CSSC membership number*

Membership numbers now start with a 3 and are 8 digits long

Your Region*

Select

Your payment details

Sort Code*

6 digits only no spaces or dashes.

PLEASE DOUBLE CHECK DETAILS - OTHERWISE PAYMENTS WILL BE DELAYED

Bank account number*

8 digits only

PLEASE DOUBLE CHECK DETAILS - OTHERWISE PAYMENTS WILL BE DELAYED

Sports membership details

Full cost of annual membership £*

Subsidy amount claiming for £*

Membership fees between £10 to £20 - 100% of fee awarded.

Membership fees over £20 - £20 maximum awarded.

Sports club name*

(Remember - We can't fund gym, leisure centre, swimming session fees, individual fitness classes or personal training costs. Also Sports Clubs already funded by CSSC). See Guidance Notes

When did you join the club?*

Sport/Activity*

File Upload*

Upload evidence of paid membership fee (this could be communication from the club or direct debit evidence (screen shot)

Drag and drop files here or

I confirm I have read the Guidance Notes and have noted the information below*

CSSC members may claim ONCE per calendar year. The subsidy must be claimed asap AFTER you have become a member of the sports club. For more information see the Guidance Notes.

Send me a copy of my responses

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