Please fill out the short form below to add your details as part of the ActiveWestminster Mark.

Full Name Organisation / Individual*
Full Name
Name of organisation or individual applying for an ActiveWestminster Mark.
Telephone*
For Public Display
Email*

For Public Display
Address*
Street Address Address Line 2 City Postcode
Website Address (if applicable)
Lead Contact Name*
Full Name
Lead Contact Job Tile / Role*
Lead Contact Telephone*
For Internal Use Only
Briefly what activities or sports does your club or organisation offer?*
- Archery
- Athletics
- Badminton
- Basketball
- Boccia
- Canoeing
- Cricket
- Cycling
- Diving
- Fencing
- Football
- Gymnastics
- Hockey
- Judo
- Karate
- Netball
- Rowing
- Rugby
- Sailing
- Squash
- Swimming
- Table Tennis
- Tennis
- Trampolining
- Triathlon
- Volleyball
- Other
Please specify
Do you provide activities tailored specifically for the following low participation groups?*
- Select All
- Women & Girls
- People with Disabilities
- Over 50s
- People from Global Majority Backgrounds
- People with medical problems related to inactivity
- People who live in socially or economically disadvantaged areas
- Young people who are not surrently participating in physical activity
- Other
Please specify
Roughly, how many different members/participants does your club work with in a year?*
Are you currently delivering sessions in Westminster?*
- Yes
- No

Write all the locations where the activities are delivered

Location Name	Address	Postcode	Actions

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