Ontario Curling Council

Quest for Gold Athlete Assistance Program

Application Form

Category: Training to Win 1 (21-29 + years old)

Instructions:

Please follow the instructions carefully. Incomplete or incorrect applications will not be scored.

Applications must be from individuals, no team applications will be accepted

Applications will be accepted from athletes over the age of 29.

Please complete the Application Form with the detailed requested, answer all questions.

Dates (month/year) and locations must be indicated, if missing, no points will be awarded

Only event results/rankings from the May 1, 2012-December 7, 2014 time period will be accepted

Do not include any “mixed” results

Do not change the form, add to the form, etc…

Applications must be submitted by December 10, 2014 at 12:00 pm EST. Late applications will not be accepted, no exceptions

Do not fill in point values or totals – Selection Committee will do that

Sign and date the application

Application Submission

All required information must be submitted no later than December 10, 2014 at 12:00 pm EST.

Applications may be mailed, couriered, faxed or emailed.

Submit to:

Tom Ward

Ontario Curling Council - Quest for Gold Athlete Assistance Program

1400 Bayly Street

Office Mall 2, Unit 2B

Pickering, Ontario L1W 3R2

Phone: (905-831-3699) Fax: (905-831-1083)

Email: tom@ontcurl.com

An email will be sent by 4:00 p.m. on December 10, 2014 confirming receipt. It is the athlete’s responsibility to contact the Ontario Curling Council if this email is not received to be certain that the application has been successfully received by the deadline date.

Applications that are sent directly to the Ministry of Tourism, Culture and Sport rather than to Ontario Curling Council will not be considered valid or to have been received by the Ontario Curling Council deadline.

Ontario Curling Council

Quest for Gold Athlete Assistance Program

Training to Win 1 (21-29+ years old)

Application Form

Male:	☐	Female: ☐

1. Name: Click here to enter text.

2. Address:	Street	Click here to enter text.

City	Click here to enter text.

PC	Click here to enter text.

3. Home Phone:	Click here to enter text.

4. Cell Phone:	Click here to enter text.

5. Email:	Click here to enter text.

6. Date of Birth (DD/MM/YY):	Click here to enter text.

Age as of Dec 31, 2013Click here to enter text.

7. Member Association: NOCA☐	OCA☐

8. Club Represented:	Click here to enter text.

9. Present Education Status (i.e. School, university, college, full time, part time)

Click here to enter text.

10. Coach Information

Coach Name:	Click here to enter text.

Coach Phone:	Click here to enter text.

Coach Email:	Click here to enter text.

Certification Level: Click here to enter text.

NCCP #	Click here to enter text.

How many years has coach worked with applicant? Click here to enter text.

*Note – Coaches must sign “Coach Acknowledgement Form” – `	applications submitted without this form will be considered incomplete.

Rankings

State your Canadian Team Ranking System (CTRS) Standing as of May 1, 2014.

Ranking:	Click here to enter text.

Skip’s Name: Click here to enter text.

Total Points: Click here to enter text.

* If you did not curl on a 2013-2014 ranked team, leave that space blank.

Applicant points will be scored as one quarter of total CTRS team points.

Total Score Section A

Competitions

Indicate exact Month/Year and Location of results

Event/Performance Standard	Month/Year and Location	Point
ex. OCA: A or B winner of zone, Compete at Region (1 point)	ex. Ajax, November 2011	1
ex. Port Perry, November 2012	1
OCA: A or B winner of zone, compete at Regions (1 point)	Click here to enter text.
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OCA: A or B winner of Regions/Challenge Round (2 points)	Click here to enter text.
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NOCA: Qualified for Provincial Championships (3 points)	Click here to enter text.
Click here to enter text.
OCA or NOCA: Win OCA or NOCA Provincial Championship (4 points)	Click here to enter text.
Click here to enter text.
OCA or NOCA: Bronze or Silver at Canadian Championship (4 points)	Click here to enter text.
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OCA or NOCA: Win Gold at Canadian Championship (5 points)	Click here to enter text.
OCA or NOCA: Medalist at World Championship (6 points)	Click here to enter text.
Total Score Section B

Other Competitions

Indicate exact Month/Year and Location of results

Event/Performance Standard	Month/Year and Location	Point
Canada Winter Games Medallist (Gold, Silver, Bronze) (5 points)	Click here to enter text.
OFSAA Regional Winner (1 point)	Click here to enter text.
OFSSA Semi-finalist (Silver, Bronze, 4th) (2 points)	Click here to enter text.
OFSSA Provincial Champion (Gold) (3 points)	Click here to enter text.
Gore OCA Provincial Winner (2 points)	Click here to enter text.
Winner, City or Area League Competition – (Year round, end of season result – please describe league – ex. City Major League – club leagues not applicable) (2 points)	Click here to enter text.
Ontario Junior Curling Tour (OJCT) 1st place = 10 points, 2nd place = 9 points, 3rd place = 8 points, 4th place = 7 points, 5th place = 6 points, 6th place = 5 points, 7th place = 4 points, 8th place = 3 points, 9th place = 2 points, 10th place = 1 point	Click here to enter text.
Total Score Section C

Post- Secondary Competitions

University or College Competitions – include team name, month/year, location

(ex. Laurier Goldenhawks, March/2012, Waterloo)

Event/Performance Standard	Month/Year and Location	Point
Played on University or College Team (1 point)	Click here to enter text.
Ontario College Provincial Finalist (2nd, 3rd, 4th) (3 points)	Click here to enter text.
Ontario College Provincial Winner (4 points)	Click here to enter text.
Canadian College Championship Silver or Bronze Winner (4 points)	Click here to enter text.
Canadian College Championship Gold Winner (5 points)	Click here to enter text.
Ontario University Provincial Finalist (silver, bronze, 4th) (3 points)	Click here to enter text.
Ontario University Provincial Winner (gold) (4 points)	Click here to enter text.
Canadian University Championship Silver or Bronze Winner (4 points)	Click here to enter text.
Canadian University Championship Gold Winner (5 points)	Click here to enter text.
World University Finalist (top 4) (6 points)	Click here to enter text.
Total Score Section D

BONUS POINTS

Annual Training Plan

Performance Planning is an important process for an athlete to achieve elite status. Annual Training Plans are key to performance planning and act as a “roadmap” for an athlete to follow to achieve their long term annual goal.

Annual Training Plans break down an athlete’s season into manageable pieces, with clear instructions on what to do on a week-by-week/month-by-month basis in all aspects of their training (Curling – Technical, Tactical, Strategical, Mental, Fitness, and Nutrition).

Annual plans help teams design their season so that they are ready to “peak” when they need to – often it will be for a “Regions,” “Provincials,” “Grand Slam”, etc…

They outline the number of practices, competitions, fitness training sessions, and Sport Science (Mental, Nutrition, etc…) sessions a team should have given the time of the year/season.

They are also great checkpoints to ensure enough rest/recovery has been built into a season.

Annual Plan Submission

The format for submission of the Annual Plan is flexible (some teams use online planners, excel spreadsheets, etc…)

Up to 2 points will be awarded (at the discretion of the Selection Committee) with more points being awarded for more detailed plans.

Fitness Training Plan

Fitness training plan with recorded results

Fitness plan must be progressive

Fitness plan may be self-designed/monitored (ie. No Personal Trainer)

Fitness plan should be appropriate to curling

Fitness Plan Submission

The format for submission of the Training Plan is flexible

Up to 2 points will be awarded (at the discretion of the Selection Committee) with more points being awarded for more detailed plans

2014-2015 Competition Schedule

Outlined planned competitions, locations and dates

Provide results for any events completed prior to December 7, 2014

The format for submission of Competition Schedule is flexible

Maximum 1 point will be awarded for the schedule

Total Bonus Points

TIEBREAKER SECTION

Note: The following information may be used if two or more individuals are tied in total score. Points acquired through the experiences below will be used to break the tie.

1. Coaching/Official/Ice Technician Training – 2 point per course or evaluation

Coaching: All NCCP Trainings and evaluations in Levels Based Program or Context Based Program eligible regardless of date taken or completed, provided they are prior to December 7, 2014.

Official Training: Level 1, 2, 3, 4 or 5. Timekeeper training does not qualify. All courses eligible regardless of date taken or completed, provided they are prior to December 7, 2014

Ice Technician’s Training – Level 1, 2 or 3. All courses eligible regardless of date taken or completed, provided they are prior to December 7, 2014

NCCP # Click here to enter text.

Courses (as described above) - 2 points each

Course Name, Date, Location	Points
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Total Points Section 1

2. Camp Participation

When reporting participation at camps, camp name, dates and locations are required.

Trillium, Amethyst, Oakville Bantam, Northern Ontario Bantam, High Performance, other Canadian camps, Fussen, Eau Claire Camp in Wisconsin, are allowable.

If other camps are noted, please give details such as date, location and length of camp.

Camps that are 3+ days in length will be awarded 2 points

Camps that are 1-3 days in length will be awarded 1 point

Ex. Ontario Talent Identification Camp, March 13, 2014, Kitchener = 1 pt

Ex. Alberta Rocks Curling Camp, July 5-10, 2014, Edmonton = 2 pts

Camp Name, Date(s) of camp, Location	Points
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Total Points Section 2

3. Camp Instruction

When reporting instruction at camps, camp name, dates and locations are required.

Trillium, Amethyst, Oakville Bantam, Northern Ontario Bantam, High Performance, other Canadian camps, Fussen, Eau Claire Camp in Wisconsin, are allowable.

If other camps are noted, please give details such as date, location and length of camp.

Camp Assistant – 1 point each camp

Camp Name, Date(s) of camp, Location	Points
Click here to enter text.
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Total Points

Camp Instructor/Coach – 2 points each camp

Camp Name, Date(s) of camp, Location	Points
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Total Points

Total Points Section 3

4. Curling Awards/Scholarships

Please provide dates, locations and brief details.

Click here to enter text. Local/Club Level, School, Community – I point

Click here to enter text. Provincial Level (recognized by a Provincial Organization – 2 points

Canadian Level (recognized by a national organization involving other provinces)

Click here to enter text. Ex. All Star Awards 3 points for 1st All Star Team, 2 points for 2nd All star Team

Click here to enter text. International Level

Total Points Section 4

5. Curling Volunteer Work

Give dates and brief details (what the curling specific volunteer work is; what period of time was involved and the number of hours involved.

Points will be awarded based on the merits of the involvement which is at the discretion of the QFG Selection Committee.

Volunteer Hours	Max points Available
Club, school level	Community(town, city) level	Provincial level(outside your town or at a Provincial event	Canadian level(recognition within Canada)
10 – 30 hrs.	1	2	3	4
31 – 60 hrs.	1.5	3	4.5	6
61 + hrs.	2	4	6	8

Within club curling, school curling etc.

Click here to enter text.

Within community (town, village, city)

Click here to enter text.

Provincial Level (outside your own town or at a Provincial)

Click here to enter text.

Canadian Level (recognition within Canada for volunteer work

Click here to enter text.

Total Points Section 5

Application Signature

By signing below I acknowledge that all of the above is true and that any false information provided will void the application.

Date:	Click here to enter a date.

Privacy Statement

The Ontario Curling Council is gathering the information provided in this application for the sole purpose of determining potential recipients of the Quest for Gold Ontario Athlete Assistance Program. When you register/apply for this program, the Ontario Curling Council may use this information in the assessment, communication and award notification with such recipients and to the community at large. In addition, the Ontario Curling Council may be required to provide this information to the Government of Ontario to ensure compliance with their program requirements and in any review by other parties of those athletes that receive an “Ontario Card” designation. The Ontario Curling Council will not release this information to any third party or curling association without the express written consent of the registrant.

Application Checklist	□	Completed Application form for appropriate category – signed and dated □	Coach Acknowledgement Form □	Annual Training Plan (Bonus) □	Fitness Training Plan (Bonus) □	Competition Schedule for 2014-2015 Season with results to date (Bonus)