Club Nomination Form

Club Nomination Form

DISABLED SPORTS ACHIEVER NOMINATION FORM

General Criteria
  • The deadline for nominations is 21st August 2016.
  • All Nominees should be active within the boundaries of Cheshire East Council.
  • You can make as many nominations as you wish, although please use a separate form for each one.
  • All nominations will be judged solely on the information received.
  • All nominations in this category will be assessed by Everybody Sport & Recreation
  • The period the nomination refers to is 1st September 2015 & 21st August 2016.
  • Nominees may enter if they were shortlisted for the 2015 awards, the nomination must be for a new initiative or significant improvement on last year’s entry

Details of person making the nomination
Name
Address
Postcode
Telephone
E-Mail Address
What is your connection with the nominee
Contact details for the nominee
Full name of nominee
Date of birth / Age
Address
Postcode
Telephone
E-Mail Address
Supporting information
What sport(s) are currently played by the nominee?
What club(s) does the nominee currently attend?
What level has the nominee competed at during the past 12 months? (Local, National, Regional)
How often does the nominee train for their sport? Are they part of a performance squad?
Please give details
How often does the nominee compete and where?
How has the nominee demonstrated a commitment to improve within their sport?
Please give details
Are there any barriers that the nominee has had to overcome in order to reach the level they have?
Please give details
Please describe any key achievements or contribution to the wider sporting community.
e.g. volunteer coach at the club, be a role model or an inspiration to other performers. Please give details
Key achievements over the past 12 months?
Please give details
Please provide any other information to support the application which is not mentioned above as to why the nominee should receive the award.
I nominate………………………………………………………… and confirm to the best of my knowledge the details given in support of this nomination are accurate. I understand that the judges’ decision is final.
Relevant agencies e.g. National Governing Bodies may be asked to endorse your application in order that details (e.g.coaching awards, membership of the NGB) can be verified.
Please do not send any additional information other than that provided in the nomination form or continued sheets from the sections above.
Signed / ……………………………………………………… / Date / …………………………….
Please return completed forms to:
By post: / Everybody Awards, Everybody Sport and Recreation, Brooklands, Holmes Chapel Community Centre, StationRoad, Holmes Chapel, Cheshire, CW4 8AA
By email: /
Any questions? If so contact 0300 123 5018
Top View