Sporting Acknowledgement Award Nomination Form

1. Individual who has excelled in their commitment to their given sport

Each Regional Sports Organisation in the North Harbour Region has the opportunity to acknowledge an individual who has excelled in their commitment in their given sport. (Administrator, sports person, volunteer etc)

Nomination criteria:

-Demonstrate the significant contribution the nominee has made to their sporting code

Question Title

* 1. I would like to nominate (nominees full name/s):

Question Title

* 2. In the sport of:

Question Title

* 3. Nominee Information

Nominees/recipients Address:

Phone number (Day):

Cell phone (Evening):

Email:

Date of Birth:

RSO/ Sports Organisation/Club name:

Question Title

* 4. Nominator Information (Your details)

Name:

Role within Organisation:

Phone number (Day):

Cell phone (Evening):

Email:

Question Title

* 5. Demonstrate the significant contribution the nominee has made to their sporting code.

Question Title

* 6. Would you like Harbour Sport to keep this nomination confidential from the recipient?

yes

If you have any further content (max 5 pages) please email harbour06@harboursport.co.nz

Question Title

* 7. Will the nominee(s) be available on the evening of Friday 25th November to attend the Awards? (This will not effect the nominee's chance of winning but simply facilitates organisation of the evening's logistics)

Yes

Question Title

* 8. I have read and understood the terms and conditions as stated below:
Conditions of entry
1. The qualifying period of the year of performance is 1st October 2015 to 30th September 2016.
2. Nominations may be received from Sports Organisations, Maori Organisations and schools.
3. Nominees must reside in or be a registered member of a North Harbour sport organisation or school. Nominations must be endorsed by the Secretary, Chairperson or CEO of the Regional Sports organisation, School Principal or Maori Sport organisation. Where there is no Regional Sports organisation for a sport, nominations must be endorsed by a North Harbour Club.
4. A team is defined as a group of athletes who contribute to a single team score i.e. netball team, swimming relay team etc and must compete for North Harbour or for a North Harbour club. All team members must reside in the Harbour region or represent North Harbour.
5. Eligible Juniors are all athletes competing in U17 age group competitions and above, and under 20 years old as at 30th September 2016.
6. The information presented on the nomination form must be clear and concise as it is used by the judges to make an informed decision. Please ensure that you include all relevant details about performances and initiatives.
7. Nominations can be made in more than one category; one nomination form must be submitted for each category. However, an individual, team or organisation will only be nominated as a finalist in one award category at the judges’ discretion.
8. The selection of finalists and winners will be made by an independent panel of judges selected by Harbour Sport.
9. The judging panel’s decision is final and no correspondence or discussion will be entered into.
10. Harbour Sport reserves the right to nominate suitable candidates if not already nominated.

Privacy act
by returning this form you are:
Consenting to Harbour Sport using these details for the purpose of administering Harbour Sport Excellence Awards and use in/for promotional purposes.
Acknowledging your right to access and correct information in accordance with the Privacy Act 1993.

Yes

Thank-you for taking the time to nominate.
An email will be sent to you and the nominee to recognise this nomination after the closing date.

Nominations close on Friday 30th September 2016 at 5pm with finalists announced on Friday 7th October 2016.

PLEASE NOTE: Someone can be nominated in more than 1 category but a separate form MUST be filled out for each category.