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Swim Programme 2024-2025 Application Form
School Details
Name of School*:
Address 1*:
Address 2:
Address 3:
Address 4:
Address 5:
Telephone No.*:
Email*:
DEIS School?*:
--Select--
No
Yes
Programme Details
Does your school currently have a swimming programme in place?*:
--Select--
No
Yes
Which pool will you be attending?*:
How many hours per week will swimming take place?*:
How many terms per school year will swimming take place?*:
Number of children swimming throughout year?*:
What classes will be catered for?
1st
2nd
3rd
4th
5th
6th
ASD Unit
Proposed Start Date:
Approximate annual cost of the swim programme
Overall Cost*:
Pupil Contribution:
School Contribution:
Grant Required*:
Please outline how this grant would benefit your programme*:
Final Details
Form Completed by:
Name*:
Position held*: