Magpie Award 2018 Nomination Form

Magpie Sports Award Nomination

To nominate for the 2017/18 Magpie Sports Award please fill in the form below. This is an Online Form so please ensure you complete all required fields before you press “Submit.” You will then recieve a “Thank you for submitting your nomination” page, this means that you have successfully submitted your nomination.
A copy of the form will be sent to us via email. There is no need to print-off and send in.

The Nominee/team MUST agree to this nomination being made and for their information to be disclosed for this purpose.
PART 1 - AWARD CATEGORY
PART 2 - INFORMATION ABOUT THE INDIVIDUAL or TEAM BEING NOMINATED
Must reside within 10km of Ashfield
If applicable
If nominating a team please disregard this question and complete age range.
If applicable
PART 3 - INFORMATION ABOUT THE NOMINATOR
If applicable
PART 4 - MAGPIE NOMINATION
Includes: Magpie | Magpie Junior | Magpie Team | Magpie Junior Team - Please proceed to Section 5 for Magpie Volunteer.
e.g. Cricket, Rugby League, Cycling, Swimming etc.
PART 5 - VOLUNTEER NOMINATION
PART 6 - SUPPORTING MATERIAL
PART 7 - MEDIA & INFORMATION RELEASE
The nominee must agree to their image and story being used publicly by Wests Ashfield Leagues Club to promote the Magpie Sports Award