We are Brimbank Sports and Wellbeing Award nomination form.

Please ensure that the nominee is aware of the nomination.

1.  Why are you nominating this individual / group / organisation?

(Minimum 200 words required)

2.  Give an overview of the project/initiative that the nominee has delivered – including its purpose, community benefits and history. (Minimum 200 words required)

3.  Leadership: How does the individual/group/organisation demonstrate community leadership in its work practices? Please give examples. (Minimum 200 words required)

4.  Contribution: How has the nominee contributed to active lifestyle and wellbeing within the Brimbank community. 

(Minimum 200 words required)

5.  As a referee for the nominee, please describe in 200 - 300 words what makes this nominee stand out in this category? 

Information to support your nomination

Feel free to attach additional materials such as photos, newspaper articles or other documentation to support this nomination. You can upload a maximum of 4 files at 10MB each. Allowed file types: jpg, png, doc, docx, pdf.

Details of secondary nominator (referee)

A secondary nominator (referee) is required to support this nomination and must be external to the organisation or group and not be an immediate family member of the club members.