Online Form - Lifetime Achievement Award

Selection Criteria

NOTE: The selection criteria period for these awards runs from October 2022 to September 2023.

Lifetime Achievement Award

Position(s) that have been held within the Club
An individual who has made remarkable and enduring contributions to their Club and local sports community over their lifetime
Demonstrated and sustained commitment to sports, excellence and achievements in their respective sports field, significant contributions to the development and promotion of sport, leadership and mentorship qualities, exemplary sportsmanship, and a positive impact on the local community
Individual whose dedication and influence have made a lasting imprint on their sport and Club

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Nominee Information

The nominee must be 18 years or over.*

The nominee is 18 years or over

Nominee's Full Name*

Nominee's Sport*

Nominee's Club*

Nominee's Postal Address

Nominee's Contact Number*

Nominee's Email Address*

Nomination Submitted By

Contact Person*

Postal Address

Contact Number*

Email Address*

Club Name*

Club Role*

Achievements

Detail applicable performances and achievements during the selection criteria period (12 months)

Please provide an explanation as to why the nominee should be recognised for the Lifetime Achievement Award. Please include their impact/involvement in sport and/or recreation and number of years involved (500 words):*

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