Swim Programme 2026-2027 Application Form

School Details

Name of School*:

Address 1*:

Address 2:

Address 3:

Address 4:

Address 5:

Telephone No.*:

Email*:

DEIS School?*:

Programme Details

Does your school currently have a swimming programme in place?*:

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*: