TEMORA & DISTRICT SPORTS COUNCIL
NOMINATION FORM
Lifetime Achievement in Sport Award
Sponsored by Col & Shirley Pike & Family
- Only financial or honorary members of the Temora & District Sports Council may nominate a person for the Lifetime Achievement award;
- Persons that have contributed a minimum of 20 years’ service to one or several different Sports in an administrative, coaching or similar roles are eligible to be nominated;
- Persons must be current active memberin some capacity of the nominating sporting club;
- The judging panel (comprising the Sports Council executive, Local Business person and representatives from TSC and Mr & Mrs Col Pike) shall determine the eventual winner and their decision shall be final;
- The winner shall be presented with the perpetual Silver Cupand a replica at the annual Sports presentation night to be held Friday 11thMay 2018, at the Temora Ex-Services Club, 6.30 sharp
- Nominations close FRIDAY 13thApril, 2018with the Secretary Judy Gilchrist P.O. Box 262 Temora 4.00pm
NAME OF NOMINEE: ……………………………………………………………………
LIST ACHIEVEMENTS AND THE SPORTS NOMINEE HAS BEEN INVOLVED IN:
…………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
If insufficient space, please attach separate sheet.
SUMMARISE THE REASONS WHY THIS PERSON SHOULD RECEIVE THIS AWARD:
……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
PLEASE GIVE DETAILS OF NOMINATING BODY
SPORTS BODY NAME: ………………………………………………………………………
POSTAL ADDRESS: ..…………………….………………………………………………
IS YOUR CLUB A FINANCIAL OR HONORARY MEMBER OF SPORTS COUNCIL? YES / NO
NAME OF PRESIDENT: ……………………………………………………………………...
NAME OF SECRETARY: ……………………………………………………………………
We, hereby approve this nomination and sign to that effect;
SIGNED: ……………………………………………………………………………
President Secretary
DATED: …………………………………………….
PLEASE NOTE:
- This award is the highest honour that may be bestowed on a local sporting identity and therefore the nominee MUST NOT be told of his/her nomination.
- If your nominee is chosen as the winner the TDSC will notify your club and family members to make sure that the winner is present on the night.
For further information contact:
Rick FirmanJudy Gilchrist Denise Breust
President Secretary Treasurer
Life Time Achievement Updated February 2018