Blaby Local Sports Alliance
Sports Awards 2016
NOMINATION FORM
Please ensure this nomination form is completed in full as far as possible with the category clearly indicated.CATEGORY OF NOMINATION: …………………………………………………………………
Name of nominee / Club:……………………………………….. Age: ______
Address: ……………………………………………………………………………………………………
Post Code: ______
Telephone Numbers (home) ______(mobile) ______
E-mail address (if applicable): ______
Sport: ______Club: ______
Key Achievements during 1st October 2015 and 1st November 2016 (Most recent first)
1)
2)
3)
4)
5)
6)
OTHER SUPPORTING INFORMATION
(not more than 200 words)Please note:
a) Selection of winners is based only on the information contained in this nomination form so please make your submission as comprehensive as possible. Additional information or press cuttings may be attached but can not be returned.
b) When completed, please send this form to: Blaby Local Sports Alliance, Blaby District Council, The Pavilion, Sports Field Lane, Huncote, Leicester, LE9 3BN. Or email to
c) Closing date for nominations is Sunday 9th October 2016.
Name of nominator
Address
Post Code
Telephone Numbers
Email address (if appropriate)
Signed
Date
Blaby District Council is registered under the Data Protection Act 1998 for the purpose of processing personal data in the performance of its legitimate business. We will use the information you have provided to deliver our annual sports awards celebratory event and to let you know about this activity in the future.
We will always treat your information fairly and in ways you would expect, and will keep the information you provide to us secure. Information about your gender, ethnicity, age and whether you have a disability will be anonymised and shared with our funding partners. You do not have to provide this information, but it helps us to secure funding to continue providing these services and to find out where we might need to target our services in the future.
We would also like to let you know about our other services and activities – please tick here if you are happy to receive this information by email
If you would like to find out about the information we hold about you, or if you want to complain about how we have handled your information, please contact the Information Management team by email to or on 0116 272 7558. You can also contact the Information Commissioner’s Office (The ICO) if you think there is a problem by email to or on 0303 123 1113.