Your Name (required)
Your Email (required)
Your Mobile Number
Your Guardian's Name (required)
Your Guardian's Email (required)
Your Guardian's Mobile Number
Your Home Address
Please provide a brief description of your sporting interests, including your current triathlon training program and recent race history (if applicable):
The Jack Boericke Foundation is a registered charity and makes awards based on need. Typical evidence of need would be based on eligibility for public benefits from other sources, such as school lunches, tax credits, housing benefit, or other needs based programs. Please list below any such benefits that you and/or your family receive, and provide any other information that you think would be helpful to us in making a determination of need:
If you have a particular funding request in mind, please describe it below. Typical funding awards might be assistance with the cost of purchasing or upgrading a bike, the cost of regular training, or the cost of an important training camp. If we think that some form of award might be appropriate, we will discuss with you the options; but it is very helpful at this stage to have an indication of what you think would be most useful.
By clicking send you confirm that all of the information provided above is true and correct and agree to update The Jack Boericke Foundation in the event of any change.