Homegrown Heroes Community Awards Nomination

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Please note, throughout this form the word "Nominee" can apply to either an individual or a group.

Nominee Details

Name of Nominee*

Address of Nominee*

Street Address

Street Address Line 2

CityState

Post Code

Phone Number of Nominee

Please enter a valid phone number

Email address of Nominee

If known

Is the Nominee over the age of 18 (as at June 2026)*

YesNo

Your Details

Nominator Name*

First NameLast Name

Address of Nominator*

Street Address

Street Address Line 2

CityState

Post Code

Phone Number of Nominator*

Please enter a valid phone number

Email address of Nominator

If you have one

Is the nominee aware of this nomination?

Selection Criteria

How long has the Nominee been a resident in the Shire of Harvey?*

If not a resident, please answer the next question

How long has the Nominee been serving the residents in the Shire of Harvey?*

Only answer this question if the nominee resides outside of the Shire of Harvey BUT their service has been within, and benefited the residents of, the Shire of Harvey

Has the Nominee been a committee member for any local group?

If the nominee is not an individual, please skip this question and move on to the next question.

What are the Nominee's achievements?*

Describe any important achievements that the Nominee has been responsible for, or made a significant contribution to, whilst serving the community.

In what ways have this Nominee's actions or service created positive outcomes or meaningful benefits for the community?*

This award celebrates individuals or teams who make an outstanding contribution to sport in the Shire of Harvey - not necessarily the top athletes, but the people/groups whose dedication, leadership and community spirit make sport possible. Whether it's a coach who goes above and beyond, a parent who volunteers tirelessly, an organiser who keeps a club thriving, or a team that fosters inclusion and participation - this award honours the champions behind the scenes who make a real and lasting difference.

If the Nominee has received previous awards, could you please provide a list of the awards bestowed?

Please limit this to a maximum of 3 years history.

Please upload any supporting documentation

Confirmation

I declare that all the above statements and attached supporting information are true to the best of my knowledge.*

I agree

Please verify that you are human*

Homegrown Heroes Community Awards Nomination - Sporting Excellence Award