Sport and Recreation Awards Nomination Form

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TERMS AND CONDITIONS OF NOMINATIONS* This field is required.Please read carefully

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YOUR NAME* This field is required.

First Name

Last Name

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YOUR EMAIL* This field is required.

example@example.com

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YOUR PHONE NUMBER* This field is required.

Area Code

Phone Number

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AWARD CATEGORY* This field is required.Please select the category for which you wish to nominate

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ASSOCIATION / CLUB* This field is required.Name of your Regional Sporting Organisation or club.

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ENDORSEMENT* This field is required.All nominations require endorsement by the appropriate club or association. Please provide the name and position of the person who is endorsing this nomination

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EMAIL ADDRESS OF THE PERSON ENDORSING THIS NOMINATION* This field is required.

example@example.com

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TEAM NAMEIf nominating a team please put the team name here. For individuals skip this question and click next.

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NOMINEE NAME* This field is required.This needs to be completed for all categories. If you are nominating a team use the captain's details here.

First Name

Last Name

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DATE OF BIRTHREQUIRED ONLY FOR EMERGING TALENT AWARDS

Date

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SPORT* This field is required.Select the main sport for which you are nominating the nominee

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SECONDARY OR OTHER SPORTSIf you wish to nominate an athlete for more than one sport, please add additional details here

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NOMINEE EMAIL * This field is required.

example@example.com

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NOMINEE PHONE NUMBER* This field is required.

Area Code

Phone Number

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LEVEL OF COMPETITION* This field is required.

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NAME OF COMPETITION* This field is required.(e.g NZ Golf Open, World Cup Rugby etc)

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ORGANISING BODY* This field is required.(e.g Tasman Secondary School Athletics, World Cup Rowing)

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SPECIFIC EVENT(e.g U16 Girls Shotput or vs Napier City Rovers)

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LOCATION* This field is required.

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DATE* This field is required.

Date

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RESULT* This field is required.(e.g. score, time, distance etc)

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WEBSITE ADDRESS FOR RESULTS* This field is required.

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FINAL RANKING* This field is required.(1ST. 2ND, 3RD ETC)

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UPLOAD SUPPORTING DOCUMENTATION

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DO YOU HAVE ANOTHER ACHIEVEMENT TO ADD

YESNO

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LEVEL OF COMPETITION

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NAME OF COMPETITION(e.g NZ Golf Open, World Cup Rugby etc)

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ORGANISING BODY(e.g Tasman Secondary School Athletics, World Cup Rowing)

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SPECIFIC EVENT(e.g U16 Girls Shotput or vs Napier City Rovers)

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LOCATION

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DATE

Date

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RESULT(e.g. score, time, distance etc)

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WEBSITE ADDRESS FOR RESULTS

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FINAL RANKING(1ST. 2ND, 3RD ETC)

37

UPLOAD SUPPORTING DOCUMENTATION

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Max. file size: 10.6MB

38

DO YOU HAVE ANOTHER ACHIEVEMENT TO ADD

YESNO

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LEVEL OF COMPETITION

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NAME OF COMPETITION(e.g NZ Golf Open, World Cup Rugby etc)

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ORGANISING BODY(e.g Tasman Secondary School Athletics, World Cup Rowing)

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SPECIFIC EVENT(e.g U16 Girls Shotput or vs Napier City Rovers)

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LOCATION

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DATE

Date

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RESULT(e.g. score, time, distance etc)

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WEBSITE ADDRESS FOR RESULTS

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FINAL RANKING(1ST. 2ND, 3RD ETC)

48

UPLOAD SUPPORTING DOCUMENTATION

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Select files to upload

Max. file size: 10.6MB

49

DO YOU HAVE ANOTHER ACHIEVEMENT TO ADD

YESNO

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LEVEL OF COMPETITION

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NAME OF COMPETITION(e.g NZ Golf Open, World Cup Rugby etc)

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ORGANISING BODY(e.g Tasman Secondary School Athletics, World Cup Rowing)

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SPECIFIC EVENT(e.g U16 Girls Shotput or vs Napier City Rovers)

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LOCATION

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DATE

Date

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RESULT(e.g. score, time, distance etc)

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WEBSITE ADDRESS FOR RESULTS

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FINAL RANKING(1ST. 2ND, 3RD ETC)

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UPLOAD SUPPORTING DOCUMENTATION

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Max. file size: 10.6MB

60

UPLOAD PHOTOS* This field is required.

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UPLOAD FURTHER INFORMATIONIf you wish to upload any further information to support this nomination do so here.

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Max. file size: 10.6MB