nomination form disability inclusion sports volunteer … · disability inclusion sports volunteer...
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sport.nsw.gov.au/disabilityinclusionvolunteer
NOMINATION FORM DISABILITY INCLUSION SPORTS VOLUNTEER OF THE YEAR 2017
The Mudgee Disability Inclusion Sports Volunteer of the Year Award recognises sports club volunteers who make a significant contribution to including people with a disability into their club’s activities.
Sporting club and association members are invited to nominate individual volunteer(s) who would be deserving of such an award. To be eligible for the award the nominee must have been a volunteer with the club or association during 2017.
Nominations must be lodged with the Office of Sport's Regional Office by 4.30pm Thursday 30 November 2017.
Nomination Criteria:
To nominate your volunteer, tell us why your nominee is the most deserving Disability Inclusion Sports Volunteer.
NOMINATION FORMCONTACT DETAILS OF NOMINATING PERSON
NOMINEE DETAILS
First name
First name
Home phone
Home phone
Why is the nominee the most worthy recipient of the Disability Inclusion Sports Volunteer of the Year award for 2017? You should complete answers for each of the below nomination criteria that is relevant for your nomination (Maximum of 50 words per criteria).
Address
Address
Postcode
Last name
Last name
Mobile
Mobile
Name of club contact
Name of club or association
Club contact phone
Relationship to nominee
Volunteer position with club or association
Time they dedicate to creating a positive sporting experience for people with a disability
Positive attitude they demonstrate towards people with a disability within their club
NOMINATION FORM
Efforts to attract more people with a disability to their club
Expertise and knowledge they bring to including people with a disability
Efforts and/or success in improving the disability access of facilities and/or equipment at the club
Encouragement they give to others in the club or association to include people with a disability
Positive attitude they demonstrate towards people with a disability within their club
Contact details:
Office of Sport76 McNamara StreetPO Box 381Orange NSW 2800Ph: 02 6362 6623 [email protected] sport.nsw.gov.au
ENTRY RULES1. Entries must be received by 4.30pm Thursday 20 November 2017. No entries will
be accepted after this time.
2. Entries can be:
• emailed to [email protected]
• posted to PO Box 381 Orange, NSW 2800
• or completed online by visiting sport.nsw.gov.au/disabilityinclusionvolunteer
3. Nominations will only be accepted for individuals (i.e. not a whole committee).
4. Multiple entries from one club or association are encouraged.
5. The nominee must have been in the volunteer position they are being nominated for during 2017.
6. Nominees must reside within the Mid-Western Regional Council area.
7. Winners will be notified by phone and mail.
8. The winner will be awarded an individual trophy, and a perpetual trophy.
9. You may be contacted to provide further information if required.
10.The additional club contact (you have provided) may be contacted to verify your nomination.
11. The judges’ decision is final and no correspondence will be entered into.
12. The competition will be judged by an independent panel of staff from the Office of Sport, Care West, Ability Links, and the Benevolent Society.
13.The winner will be announced and presented at the annual Mudgee Sports Council Awards in February 2018.